HealthInfo Canterbury
Broken wrist
Kawititanga tāwhatiwhati o te ringa
Your wrist is made up of eight small bones called carpal bones and the two long bones in your forearm (the radius and ulna). Your wrist moves where they connect.
This makes your wrist a very complex structure, as there are many different joints within it.
If any one of your carpal or forearm bones breaks, it can change position slightly, causing pain and problems with movement and hand use.
Causes of a broken wrist
A broken wrist usually happens from falling onto an outstretched hand. Accidents, such as car or motorcycle accidents or falls from a ladder can cause more serious breaks.
If you break your wrist without significant force, your doctor may recommend checking if you have osteoporosis. If you meet the criteria, they may send you for a bone density scan.
Any of the bones in your wrist can break, but the most common bone to break is the radius in your forearm. This is called a distal radius fracture.
Another common wrist fracture is a scaphoid fracture, which is a break in one of your small carpal bones. This can be difficult to diagnose, and there's a risk a scaphoid fracture might not heal, and this might lead to arthritis in the future.
Your wrist can break in many different ways and some breaks are worse than others. How bad a break is depends on how many pieces the bone breaks into, whether they're stable or move around a lot, and whether the broken ends of the bone are still in the right place.
Diagnosing a broken wrist
If you've broken your wrist, it will be painful and swollen. It may be hard to use your hand or wrist. Your wrist may seem to be deformed because it's swollen, or a bone is out of place. You may feel pain just where it's broken or whenever you move your fingers. Your fingers may tingle, or your fingertips may be numb.
Some people can still move or use their hand or wrist and assume they've just sprained it. The break may only be diagnosed some weeks later when they see a doctor because the pain isn't going away, or they can't move their wrist as well as usual. This is more common with a broken scaphoid bone.
If you think you may have broken a bone in your wrist, it's important to see a doctor.
Your doctor will ask about how your injury happened, look at your hand and take X-rays to find out which bone is broken and what kind of break it is.
Because it can be difficult to see some wrist fractures in X-rays, your doctor may put your hand in a cast then ask you to return a week later for another X-ray. They may also X-ray above and below where you're sore to check if you have any other nearby injuries.
It's possible you'll also have a CT scan, which can show a complex break more clearly, or an MRI, to show any soft tissue injury.
Treating a broken wrist
The way your broken wrist will be treated depends on many different factors, including:
- the type of fracture and whether the bones have moved or are unstable (meaning they could move around)
- whether a bone has broken through your skin (an open wound)
- how old you are
- your job, hobbies and activities
- whether your dominant hand is injured
- whether you have other injuries as well
- how good your overall health is.
You may need surgery to put the broken bone back into the right place and hold it there until it heals if:
- the break is unstable (the bone can move out of the right position)
- the bone has broken into many pieces
- the bone has broken where it forms a joint with another bone.
Less complex breaks that are stable (the bones don't move around) usually don't need surgery but need a cast to hold them in the right place while they heal. The cast will probably start at your knuckles and go almost all the way to your elbow. This helps to keep your wrist bones in the right place while they're healing.
If the ends of the broken bone are not properly lined up, your doctor may need to move them back into place before you get your cast. You probably won't need surgery for this.
You'll wear the cast for four to six weeks but can probably start doing some gentle hand exercises after three weeks.
You'll still have to take special care of your hand and wrist once the cast comes off.
Sometimes a break seems to be stable and is put in a cast, but as the swelling goes down the broken bones move apart and need surgery to put them back in place. For this reason, you'll have regular X-rays while your wrist is in a cast to make sure the bones stay in the right place while they are healing.
Self-care for a broken wrist
There are several things you can do yourself to help your wrist heal, whether or not you're having surgery.
- If you're a smoker, stop smoking. Continuing to smoke will slow down how quickly you heal.
- Don't do any heavy lifting or gripping with the affected hand, as this will increase your pain and slow your recovery. You may need some time off work to let your wrist recover. But it's important to keep using your hand lightly.
- Take regular pain relief. The best pain relief is paracetamol (Panadol). Take two tablets every four hours but take no more than eight tablets a day. Avoid anti-inflammatories as they may slow down how quickly your bones heal.
- Swelling can lead to further complications. To reduce the swelling, keep your wrist raised (elevated) above the level of your heart whenever possible. Also apply ice (wrapped in a towel or plastic bag) to your hand or arm above the cast. Don't put ice directly on your skin, as this can burn it. Take care not to get the cast wet. Keep all the arm joints moving that aren't limited by the cast – your shoulder, elbow, thumb and fingers.
- If you're in a lot of pain, your wrist stays very swollen, you can't move your fingers well and you're struggling to cope, see your GP, hand therapist or physiotherapist as soon as possible. If your cast is tight or restrictive, contact the hospital or health centre that put your cast on to have it changed as soon as possible.
On the next page: Surgery for a broken wrist
Written by HealthInfo clinical advisers. Last reviewed June 2022.
Sources
Review key: HIWAH-240323
