Falls, accidents and osteoporosis can contribute to a wrist fracture, which is a break or crack in one of the bones in the wrist. Wrist fractures may affect one of the two bones in the forearm, the ulna or radius, or one or more of the 8 small bones at the base of the hand. Treatment for wrist fractures usually involves casting the injured area.
Diagnosis
X-rays are used to determine if there is a fracture in one or more bones of the wrist. X-rays are helpful in locating many fractures, but may not be as effective in revealing cracks in bones. If your doctor suspects you may have broken or cracked a bone in your wrist, but an X-ray does not support this suspicion, you may be asked to undergo another test, such as magnetic resonance imagining (MRI) or computed tomography (CAT) scan. These tests produce much more detailed images of bones than an X-ray can. They can also provide detailed images of muscles and nerves, allowing your doctor to diagnose other related injuries, such as torn ligaments or nerve damage.
Splinting and Casting
A splint, a rigid device that supports the wrist and keeps it from moving, may be used if your bones are in proper alignment after the fracture. You may need to wear the splint and keep your arm in a sling for up to a week until swelling from your injury subsides. Once swelling has subsided, a plaster or fiberglass cast will be applied to the wrist and worn for up to six weeks. The cast is very hard and protects your wrist from further injury while it heals. The cast also helps hold your wrist in alignment, allowing your bones to heal correctly. If there is a significant amount of swelling initially, your cast may be replaced with a tighter-fitting cast one or two weeks after your fracture.
Closed Reduction
A reduction may be needed if your bone is not in the proper position after your fall or accident. During a closed reduction, your doctor manipulates your bone without surgery and maneuvers it back into the proper position before a splint or cast is applied. According to the American Society for Surgery of the Hand, if the bones are not aligned before healing takes place, motion may be limited in the joint when it heals and the risk of pain and arthritis may be increased.
Surgery
If your bone cannot be moved back into place using a closed reduction, an open reduction will be needed. During an open reduction, an incision is made in your wrist, allowing your doctor to reach the bones and place them into alignment. If the fracture is particularly severe or if there are several bones involved, metal plates, pins and screws may be attached to the bones to allow them to heal in the correct position. In some cases, an external fixator, a device that is attached to the bones and protrudes through the skin, is used to maintain alignment while the bones heal. If bone is crushed or missing, a bone graft may be needed to restore use of the joint. During a bone graft, a small amount of bone is taken from another area of the body, such as the hip, and used to build up existing bone in the wrist.
Recovery
Pain medications and ice may be helpful in relieving pain while the fracture heals. According to the American Academy of Orthopaedic Surgeons, combining ibuprofen and acetaminophen is more effective in reducing pain than using one of these medications alone. The wrist may feel stiff for one or two months after your cast is removed, but the stiffness should gradually diminish with time. Physical therapy and special exercises may be helpful in maximizing the strength and function of the healed fracture.
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