Wrist Fracture

What is a Wrist Fracture?

A wrist fracture occurs when there is a break in one or more of the bones in the wrist. The wrist comprises eight small carpal bones and the distal ends of the forearm bones, the radius and the ulna. Wrist fractures are among the most common bone injuries, frequently resulting from falls, sports activities, and accidents. The type and severity of a wrist fracture can vary, with some requiring minimal treatment and others needing surgical intervention.

Types of Wrist Fractures

Colles’ Fracture

A Colles’ fracture is characterised by a break in the radius bone of the forearm, just above the wrist, leading to the displacement of the wrist and hand backwards. It commonly occurs when individuals fall onto an outstretched hand.

Smith’s Fracture

This type of fracture is similar to the Colles’ fracture but results in the wrist being displaced towards the palm. It often happens due to a fall on a bent wrist or a direct blow to the back of the wrist.

Barton’s Fracture

Barton’s fracture involves a break at the base of the distal radius with dislocation of the radiocarpal joint. This injury usually occurs from a fall on the top of a bent wrist, causing a compression injury to the wrist joint.

Symptoms

The symptoms of wrist fractures depend on the fracture’s nature and severity.

• Pain
  Immediate and acute pain is typically felt at the moment of injury. The pain usually intensifies when pressure is applied or the wrist is moved.
• Swelling and Bruising
  The area around the fracture often swells and bruising can develop, indicating tissue damage and internal bleeding.
• Deformity
  A noticeable deformity, such as an unnatural angle of the wrist or a visible bump, is a clear sign of a severe fracture.
• Impaired Mobility
  Movement of the wrist or hand is often restricted and accompanied by pain. This includes difficulty in performing simple tasks like gripping or lifting objects.
• Numbness or Tingling
  In some cases, there may be numbness or tingling in the fingers, suggesting nerve involvement. This symptom may indicate more complex damage.
• Audible Snap or Pop
  At the time of injury, some individuals may hear a snap or pop, indicative of a bone fracture.

Causes and Risk Factors

Wrist fractures can occur due to a variety of causes and risk factors:

• Falls: The most common cause of wrist fractures is a fall onto an outstretched hand. This can happen in daily activities, sports, or accidents.
• Sports Injuries: Athletes, particularly those involved in contact sports or activities with a risk of falling, such as skating or skiing, are at higher risk.
• Motor Vehicle Accidents: High-impact trauma, like car accidents, can cause severe wrist fractures.
• Weak Bones: Poor nutrition, low bone density or osteoporosis can weaken the bones, making them more susceptible to fractures even with minor falls or stresses.
• Improper Technique and Equipment: Utilising incorrect techniques or using deteriorated equipment, such as gloves, can exert undue pressure on the wrist.
• Insufficient Warm-Up: An athlete’s body, when not properly conditioned to meet the specific demands of their sport, becomes more susceptible to sustaining injuries.
• Age-Related Factors: Older adults are more prone to wrist fractures due to decreased bone density and balance issues.
• Previous Fractures: Individuals who have had wrist fractures in the past are at an increased risk of future fractures.

Non-Surgical Treatment Options

Non-surgical management of wrist fractures focuses on immobilisation and pain relief, tailored to the specific type of fracture.

Splints and Casts

Initial treatment often involves a splint to allow for swelling. Once the swelling subsides, a cast is applied to keep the wrist immobile and ensure proper bone alignment and healing. The duration of wearing a cast varies but typically lasts for about six weeks.

Medication for Pain Management

Pain relief is achieved using over-the-counter medications like ibuprofen or acetaminophen. In cases of more severe pain, prescription painkillers may be necessary. Their use should be closely monitored due to potential side effects.

Physical Therapy

Once the bone has sufficiently healed, and the cast is removed, physical therapy can be conducted. Therapy focuses on regaining wrist strength, flexibility, and range of motion. Exercises are gradually intensified as healing progresses.

Activity Modification

During the healing process, activities that may strain the wrist are avoided. Guidance will be given on how to modify daily activities to prevent further injury and facilitate healing.

Surgical Treatment Options

Surgical intervention for wrist fractures is considered when non-surgical methods are insufficient, particularly in complex or unstable fractures.

Prevention Strategies

Preventing wrist fractures involves measures to reduce the risk of falls and injuries.

• Environmental Safety: Ensure living and working spaces are free of hazards that could cause falls, such as loose rugs or wet floors.
• Protective Gear: When engaging in sports or activities like skating or cycling, use protective gear like wrist guards.
• Bone Health: Maintain bone strength and density through a diet rich in calcium and vitamin D, and engage in regular weight-bearing exercises.
• Fall Prevention Techniques: Particularly for the elderly, implementing fall prevention strategies like using handrails and avoiding risky activities can help reduce the threat.