Wrist Fracture: Causes, Symptoms & Treatment

A wrist fracture is a fracture of the wrist. It usually results from a fall and is one of the most common fractures. Treatment is similar to that for other fractures. Wrist fracture can also be prevented.

What is a wrist fracture?

A wrist fracture is a fracture of the radius (radius). It most often occurs when you try to catch yourself with your hand during a fall. Since this reflex almost always occurs, fractures of this type are common. In rare cases, the wrist fracture can also result from a fall on the flexed hand. In this case, it is called a flexion fracture. A fracture of the wrist can be treated by wearing a cast. Taking medication is also useful because of the pain.

Causes

A wrist fracture is usually caused by a fall on the hand. This causes the joint to break or sprain. Elderly people and children are most likely to be affected, as they fall more often. Children who fall while playing try to break the fall with their hand and thus cause a fracture. In older people, reduced bone stability is also an important factor. As a result, a fall quickly results in a fracture of the wrist. Osteoporosis (bone loss), which occurs more frequently in old age, increases the risk of fracture. In addition, older people are at increased risk due to other complaints. For example, dizzy spells, weakness in old age and cardiac arrhythmias lead to falls. In conjunction with reduced bone stability, serious fractures subsequently occur. The cause is therefore always excessive pressure on the wrist, which leads to the fracture. This is usually triggered by a fall, but a jammed arm, an unnatural posture during sports or violence can also lead to such a fracture. Various factors also favor the risk that the bone is not only sprained, but broken.

Symptoms, complaints and signs

A wrist fracture typically manifests as severe pain in the affected extremity. The pain usually occurs immediately after the injury and is sharp or throbbing. Since the pain is particularly intense during movements, the affected person usually automatically adopts a protective posture. The pain is accompanied by swelling and redness in the affected area. The joint can only be moved to a limited extent or not at all, depending on the location and severity of the fracture. A sure indication of a fracture is a visible malposition of the wrist. If the hand is bent outward or backward, for example, or is at an unusual angle from the arm, a fracture can be assumed. A wrist fracture is also manifested by an unusual crunching sound or other noises during movement. Occasionally, numbness or paralysis may also occur. If important vessels are injured, there may also be circulatory problems and major swelling. The symptoms of a wrist fracture increase in intensity until the fracture is treated. If treatment is not received, fainting pain and accompanying physical symptoms such as nausea and vomiting quickly set in.

Diagnosis and course

A wrist fracture can be diagnosed unequivocally. The symptoms that occur are clear and can be associated with a fracture by the affected person himself. Thus, on the one hand, a painful swelling occurs in the area of the wrist and, on the other hand, there is a malposition of the affected joint. However, the second symptom does not always occur. The exact location of the fracture is decisive. Accompanying these symptoms are sensory disturbances of the hand or fingers. The skin and muscles may also be injured. If these symptoms are present, it is advisable to consult a doctor. He or she can perform a comprehensive medical examination to clarify the extent of the damage. Wrist fractures are often accompanied by injuries to nerves and vessels. The medical history also clarifies how the accident occurred and how exactly the wrist is broken. This allows the treating physician to directly rule out certain types of fractures. To confirm the diagnosis, an X-ray examination is performed. The wrist is imaged from above and from the side to provide an optimal view of the affected area.Finally, it must be clarified whether the fracture is unstable or stable. The subsequent therapy is based on this. The course of the fracture depends on the extent of the fracture. In children, the joints usually heal again within a few weeks. The extent of the physiotherapeutic follow-up treatment is also decisive. A complicated fracture involving damaged ligaments and nerves usually requires treatment for several months before it is completely healed.

Complications

In most cases, a wrist fracture heals without complications. Problems can occur if the fracture is not treated or is treated inadequately. For example, a delayed fracture can lead to permanent sensitivity problems, chronic pain, and deformity. In half of all cases, surgical intervention can lead to renewed malpositions, which must be corrected in a further operation. Possible bone displacements can also lead to damage to the surrounding nerves, blood vessels and soft tissues. In the worst case, this leads to so-called Sudeck’s dystrophy and the complete loss of function of the hand. Sudeck’s disease mainly affects women of advanced age, but patients with previous bone disease are also at risk of Sudeck’s dystrophy. In addition, ischemic contractures, compartment syndrome, or fat emboli may occur, usually associated with further complications. False joint formation (pseudoarthrosis) in the wrist may also occur. As a result of a fracture, wear and tear may also occur or the joint may stiffen completely. Finally, the prescribed painkillers can cause side effects. With early and comprehensive treatment, serious complications can usually be avoided.

When should you see a doctor?

When a wrist fracture occurs, an appropriate physician should always be consulted. A person suffering from a wrist fracture will be in excruciating pain, so going to the doctor should be immediate. If medical and drug treatment is foregone, the fracture may not knit together properly. In some cases, surgery may also be required to straighten the fractured bones. Only through such medical intervention can a complete and rapid recovery occur. Follow-up examinations are also very important later in the healing process so that possible complications can be detected and treated at an early stage. If a doctor is consulted quickly in the event of a wrist fracture, then the chances of a full recovery are very good.

Treatment and therapy

The treatment of a wrist fracture is unproblematic. First, the bones are restored to their original shape, which requires either surgery or conservative (non-surgical) intervention. In case of a simple fracture of the wrist, a non-surgical therapy is sufficient. With the help of an X-ray fluoroscopy device, the wrist can be brought into the correct position. A plaster cast is then applied to protect the bones and support healing. Part of the therapy also includes various movement exercises of the fingers and elbow, with the help of which the sensitivity disorders are remedied. Depending on how serious the wrist fracture is, other measures may need to be taken to treat damaged nerves and ligaments.

Outlook and prognosis

A wrist fracture has a good chance of healing if the fracture is stable. After a few weeks of rest and sparing of the affected hand, recovery occurs in most patients. Complete freedom from symptoms is achieved after a few months. The older the patient, the longer the healing process normally takes. Early stress on the hand should be avoided in the case of a fracture. Physical activities should be built up slowly after the healing process is complete to avoid long-term consequences. Despite the good outlook, complications can occur. In addition to circulatory problems, restrictions in mobility and a permanent reduction in performance, the patient is at risk of a malposition of the wrist. This can occur with a complicated fracture or problems during the healing process. Timely medical care and immediate correction of bone damage are necessary to prevent long-term damage, if possible.Some patients complain of chronic pain for years or suffer osteoarthritis as a late consequence. The prognosis worsens if bone or joint disease is already present. In the case of a repeated wrist fracture, the prospects of recovery are also diminished. Complete recovery is possible, but the risk of sequelae is significantly increased if the fracture occurs again. In most cases, the usual level of performance is no longer achieved in these cases.

Prevention

A wrist fracture can be prevented primarily by taking protective measures during certain sports. For example, it is recommended to wear appropriate protective clothing during high-risk activities such as in-line skating. It can also help to strengthen bones and detect osteoporosis at an early stage. Older people in particular can minimize the risk of wrist fracture by taking preventive measures and having dizzy spells or similar disorders treated.

Follow-up care

A fracture of the wrist can occur in varying degrees of severity, so appropriate follow-up care may be urgently needed. In any case, a fracture of the wrist should be treated medically or surgically. Only in this way can a quick and smooth healing take place. If the affected person decides against appropriate treatment, then considerable complications are to be expected. Without professional immobilization of the entire wrist, complete recovery or healing is not possible. Severe inflammation can occur, which may even be life-threatening. After treatment or surgery, aftercare is very important so that the fracture can grow together in peace. The joint should therefore not be subjected to any stress. In this context, it is just as important to keep control visits. Through such control examinations, any complications can be detected early and eliminated accordingly.

What you can do yourself

If a wrist fracture is suspected, the joint must first be immobilized and cooled. If possible, the injured limb is padded with appropriate material and elevated until the emergency physician arrives. Independent attempts to move or set the joint must be avoided. After the initial treatment, the doctor in charge will explain necessary measures for a quick recovery. In most cases, physiotherapeutic treatment is recommended, which can be supported by light everyday exercises. However, the wrist must be immobilized for the first few weeks. After that, osteopathic therapy may be useful. So-called therapeutic plasticine can be used for everyday life. Aftercare also includes comprehensive wound care. Depending on how the wound heals, the dressing should be changed two to three times a week at the most. If the skin begins to itch, it may help to lift the cast slightly and blow it out with a hair dryer on a low setting. Again, discuss any measures with the responsible physician beforehand. This also applies to the use of any natural remedies. Medicinal plants such as comfrey or arnica support wound healing and are particularly effective in the acute healing phase.