Broken Wrist – Diagnosis and Treatment
Diagnosis
Doctors start by looking for symptoms like pain, swelling, bruising, and tenderness around the wrist and forearm.
They might ask about recent falls or injuries and check how strong your grip is. A physical exam of the wrist helps find any changes in movement or signs of a broken bone.
Doctors usually order X-rays first. X-rays can spot breaks in the distal radius, ulna, or carpal bones. They also show if the fracture is a Colles fracture, comminuted, intra-articular, extra-articular, or an open fracture.
Alternative Imaging Methods
If X-rays miss something or more details are needed, doctors turn to other scans. CT scans can reveal wrist fractures that are hard to see on standard X-rays and help find injuries to soft tissues or blood vessels.
MRIs help find small fractures or ligament damage that X-rays do not show. Sometimes, doctors use a bone scan to detect hidden fractures, especially in tricky spots like the scaphoid bone.
Treatment
Keeping the Bone Still
To help a broken wrist heal, keeping the bone from moving is very important. Most people will need a splint or a plaster cast to hold the wrist steady.
| Tool | Purpose |
|---|---|
| Splint | Temporary support, allows for some swelling |
| Cast | Strong support, keeps wrist in one position |
| External Fixator | Holds bones from the outside using metal pins |
Sometimes, a healthcare provider uses a splint at first if there is swelling, and then switches to a cast once the swelling goes down.
It is helpful to keep the hand lifted above the level of the heart. This can lower swelling and help manage pain.
People should try to gently move their fingers if their doctor says it is safe, to avoid stiffness. The most common tools for immobilization include:
Pain Relief and Medicines
To ease pain, most doctors first suggest medicines you can buy without a prescription. These may include acetaminophen or similar options. Sometimes doctors prescribe stronger pain medicines for a short time.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can also relieve pain, but long-term use may slow bone healing. Always check with a doctor about which pain medicine is safe.
If the broken bone has cut through the skin (called an open fracture), doctors give antibiotics to lower the risk of infection in the bone.
Exercise and Movement Programs
Once a cast or splint is taken off, getting back grip strength and normal movement is a big part of recovery. Physical therapy or special exercises help return the wristโs range of motion and flexibility.
Rehabilitation could go on for several months, depending on the injury. A therapist may suggest a range of motion and strengthening movements to help with daily tasks and lessen stiffness.
The main steps of therapy include:
- Stretching exercises for the wrist and fingers
- Strength training to rebuild muscle
- Activities to improve hand use in daily life
Operations and Other Advanced Methods
Doctors may recommend surgery if the broken pieces donโt stay together after being set or if the break is bad.
When surgery is needed, doctors might use metal pins, plates, rods, or screws to keep the bones in place while they heal.
This is called internal fixation. Sometimes doctors perform an open reduction procedure to line up the bones before securing them.
For some wrist fractures, doctors use an external fixator. This is a metal frame that holds the bone from the outside with pins going through the skin and bone. In rare cases, a bone graft helps healing.
After reduction with casting or splinting, doctors usually order follow-up X-rays. If the bone shifts, surgery might be the next step. The choice of treatment depends on the type of break, where it is, and if other tissues are hurt.
Getting Ready for Your Visit
Steps You Can Take Before Seeing the Doctor
Before your appointment, it helps to come prepared. Make a list with the following information:
- Details of Symptoms: Write down where the pain is located, what caused the injury, and when it happened.
- Personal and Family Medical History: Include any history of bone problems such as osteoporosis.
- Medications and Supplements: List everything you take, with amounts.
- Questions for Your Provider: Itโs useful to ask about your treatment options, possible need for surgery, how long recovery might take, and if physical therapy will be needed.
Possible Questions to Ask:
| Questions to Consider |
|---|
| Which tests will be done? |
| Is surgery needed? |
| Will I require a cast, and for how long? |
| Are there any activities to avoid? |
| Is therapy needed after healing? |
What Your Healthcare Provider May Ask You
Expect your doctor to ask some questions to understand your situation better:
- What work do you do?
- Did you force your wrist backward or forward?
- Which hand is your dominant one?
- Where do you feel pain, and what motions make it worse?
- Have you had bone problems like osteoporosis or previous injuries to this wrist?
Bring notes and be ready to answer these questions to help your visit go more smoothly.
