The wrist constitutes eight small bones and two forearm bones namely; the radius and ulna. These bones form multiple large and small joints. The bones are attached by ligaments and at each joint, the ends of the bones are rimmed with cartilage. The peculiar shape and design of these joints enables the wrist to straighten and bend, rotate or move from side to side.
The basic structures of the wrist thus include:
- Forearm, wrist and hand bones
- Carpal bones of the wrist
Wrist fractures are most common in patients under 65 years of age. A typical wrist fracture involves a fracture of the radius or one of two forearm bones. Other bones that are prone to fracture near the wrist joint include the scaphoid and the ulna.
The two main types of wrist fractures include:
- Fractures of the radius or ulna
- Fractures of the carpal bones
An open or compound wrist fracture happens when a bone fragment breaks through the skin. There is a greater risk of infection in the case of compound wrist fractures. On healing, the significantly altered position or alignment of the bones may even affect the function of the wrist. This could lead to permanent limitations in motion with a higher risk of arthritis.
Causes of wrist fracture:
- Falling down onto an outstretched hand results in excessive force on the wrist.
- Forceful injury, such as a car accident or falling off a roof or ladder.
- Osteoporosis, a condition in which the bones become thinner and highly brittle
Signs & Symptoms:
- Wrist pain
- Swelling and inflammation
- Deformity of the wrist
Physical examination and x-rays are required to assess the extent of fracture and the position of the bones and to determine the appropriate treatment. Sometimes, a CT scan may be helpful to get a comprehensive and lucid view of the fracture fragments.
The treatment may vary depending on various factors such as age of the patient, activity level, occupation, hand dominance, prior injuries, and medical history. Your surgeon will determine what kind of treatment is the most appropriate for you.
Some of the treatment options are:
- Wearing a splint or cast either to protect a fracture that has been set or to treat a fracture that is not displaced.
- Stabilizing a fracture with pins, screws, plates, rods, or external fixation.
- If a bone in the wrist is missing or severely crushed that there occurs a gap in the bone after it has been re-aligned. In such cases, a bone graft may be required.
- Sometimes, arthroscopy is used in the treatment of wrist fractures.
Recovery and Rehabilitation
Always keep your fingers and shoulder flexible while the wrist fracture is healing. Once the wrist has sufficient stability, motion exercises could be started for the wrist. Hand therapy is often recommended to patients to help recover strength, flexibility and function.
The recovery time varies significantly, depending on the extent and severity of the injury and other factors as mentioned earlier. Recovery from a wrist fracture could even take several months. Sometimes, additional treatment or reconstructive surgery may be needed.