Hand/Wrist Fractures

Injuries to the bones in the hand and wrist are very common among all age groups and often occur due to a fall on an outstretched hand. Fractures of the wrist can involve several different bones that surround the joint, including the two bones in your forearm, the radius and the ulna, as well as a multitude of tiny bones in the base your hand, called carpal bones. The radius is the bone on the thumb side of your wrist and arm, and the ulna is the outer bone located on the side of your little finger.

When you have a fractured wrist, it usually causes immediate pain along with tenderness, bruising and swelling. Your wrist may hang or appear bent, and you may not be able to make a fist. Pain can subside, just to return as a deep, dull ache with sharp tenderness when pressure is applied between the tendons leading to the thumb.

When you fracture a finger bone, it can cause your whole hand to go out of alignment - as bones in the hand line up very precisely. Without treatment, a broken finger can remain inflexible and painful. Many signs and symptoms of a broken finger are similar to those of a wrist fracture: swelling, pain and tenderness. Other symptoms specific to a finger fracture include the inability to move it, a shortened or deformed finger, a depressed knuckle or a finger that crosses over the next when you try to make a fist.

The most common wrist fracture occurs at the end of your arm's radius bone – called a distal radius fracture. The radius is the larger of the two bones of the forearm and it is the most commonly broken bone in the arm. Distal radius fractures account for over 15% of all broken bone injuries seen in emergency rooms. The distal end of the radius bone is particularly susceptible to fracture because it comprises nearly 80% of the wrist joint surface and bears nearly the full load from a fall on an outstretched hand.

To determine treatment, your physician will take x-rays to establish exactly what damage occurred to your bones. In complex cases, an MRI or CT scan may be necessary. The treatment of wrist fractures varies and depends on the many things like the location of the fracture, its position and stability, as well as how many bone fragments were created in the break. Most wrist fractures can be treated without surgery. Bone fragments are gently pushed into their regular position, and then your wrist, hand or finger is placed in a cast or splint while it heals. Physical therapy or a program of exercises will be recommended after the cast or splint is removed and in a few months, you will likely be able to resume light to normal activity levels.

There are indeed occasions when wrist or hand fractures require surgery and the reasons vary. Some fractures are so unstable that a cast alone cannot hold the bone pieces together in normal alignment. Also, some bones when fractured more typically require surgery. Of course, each case is individual and the optimum treatment will be based on the specific injury, its simplicity or complexity, the patient's age and general health.

Outcomes for patients with wrist or hand fractures are usually very good, though some might experience stiffness or loss of motion. Complexity of the injury, the timeframe in which the treatment occurs, as well as the patient's cooperation in treatment can all impact outcomes.