Broken Wrist (Wrist Fracture)

What is a broken wrist?

A broken wrist, or wrist fracture, can occur in any of the 10 bones that make up your forearm and wrist. These include your:

• Radius: Larger forearm bone.
• Ulna: Smaller forearm bone.
• Carpal bones: Eight small bones located at the base of your hand.

The most common broken wrist bone is the radius. Hand surgeons call this a distal radius fracture.

Types of wrist fractures

You can break a bone in your wrist in several different ways. These include:

• Colles fracture: A Colles fracture occurs when you fall on an outstretched hand with your wrist bent backward. The broken end of your radius tilts upward, toward the back of your hand.
• Smith fracture: A Smith fracture occurs when you fall with your hand bent forward. The broken end of your radius tilts downward, toward the palm side of your hand.

Hand surgeons may classify wrist fractures further into categories, including:

• Intra-articular fracture: A fracture that extends into your wrist joint.
• Extra-articular fracture: A fracture that doesn’t extend into your wrist joint.
• Open fracture: A fracture that breaks the skin and requires immediate medical attention due to the risk of infection.
• Comminuted fracture: A fracture that involves a bone that’s broken into more than two pieces.

How common are broken wrists?

In the U.S., more than 450,000 bone fractures occur every year. Distal radius fractures make up about 1 out of every 6 fractures.

How can you tell if your wrist is broken?

Broken wrist symptoms may include:

• Severe and persistent pain.
• Swelling.
• Tenderness.
• Bruising.
• Stiffness.
• Bent wrist or other bone deformity.
• Numbness at the tips of your fingers.

What causes a broken wrist?

The most common cause of a wrist fracture is falling on an outstretched hand with your wrist bent back or forward to break your fall.

Wrist fractures occur for different reasons in younger people compared to people over the age of 60. In younger people, high-energy incidents tend to cause fractures. These incidents may include falls from heights (like a ladder), car accidents and sports injuries.

In people over 60, low-energy incidents more often cause fractures. These incidents include falls from a standing position.

What are the risk factors?

Wrist fractures are more common in people with osteoporosis, which is a condition that weakens your bones. Other risk factors in people over the age of 60 include:

• Decreased bone mineral density (osteopenia).
• Being assigned female at birth (AFAB).
• Being white.
• Biological family history.
• Early menopause.

What are the complications of this condition?

Complications of a broken wrist may include:

• Rupture of a tendon in your arm.
• Carpal tunnel syndrome.
• Compartment syndrome.
• Complex regional pain syndrome.
• Arthritis in your wrist.

How is a broken wrist diagnosed?

Your healthcare provider will perform a physical examination, where they’ll carefully feel and gently bend your wrist in different directions. They’ll also ask you about your symptoms and medical history. They’ll want to know how you injured your wrist.

To make a proper diagnosis, your provider will request a wrist X-ray. You may need additional imaging tests to diagnose other injuries involving your ligaments, tendons, nerves and muscles. These tests include a CT scan (computed tomography scan) or an MRI scan (magnetic resonance imaging scan).

How is a broken wrist treated?

Treatment for a wrist fracture depends on several factors, including:

• The type of fracture.
• The severity of your fracture.
• The presence of other injuries.
• Your age, activity level and whether it’s your dominant hand.

The first step in treatment is making sure the broken pieces are put back into the correct position. You need to prevent them from moving out of place until they’re healed. If the bone is in the right position, your provider may just apply a cast until the bone heals.

If the bone is out of place, your provider may need to realign the bone fragments first. This procedure is called reduction.

Closed reduction

A closed reduction is a nonsurgical procedure. It means your provider can straighten your bone without having to open your skin. After your provider has properly aligned your bone, they’ll place your arm in a splint or cast to keep the bones aligned. They’ll usually recommend a splint for the first few days to allow for swelling. A few days to a week later (after the swelling goes down), you’ll be fitted for a cast. You may need to have your cast changed as the swelling continues to go down.

Your provider may closely monitor your healing by taking weekly X-rays for at least three weeks. Then, you’ll have another X-ray at six weeks. At this point, your provider may remove the cast and have you start physical therapy to help improve your wrist function and motion. You may continue to wear a splint to protect your wrist.

Open reduction

An open reduction is a surgical procedure. It means your provider can’t correct the position of the broken bone through a closed reduction. Your provider will make a cut (incision) through the skin on your wrist to access the fracture. They’ll realign your bones through this incision. Then, they’ll use one or more of the following options to hold your bone in the correct position while it heals:

• Cast.
• Plate and screws.
• Metal frame with pins.
• External fixator (a frame of rods outside your body that holds the bones in place so they can heal).

Can a broken wrist be prevented?

Many wrist fractures occur due to high-energy falls and other accidents, so they’re difficult to prevent. But having good bone health can help prevent wrist fractures in people over the age of 60. Talk to your healthcare provider about how you can keep your bones strong, especially if you have osteoporosis.

How long does it take a broken wrist to heal?

Recovery time for a broken wrist depends on several factors, including the severity of your fracture and the method of treatment. For closed reduction procedures, you may wear a splint for a few days to a week followed by a cast for four to six weeks. After that, it can take up to three months or more before you’ll be able to fully return to your typical activities. Open reduction procedures take longer to heal.

During your recovery, your provider may advise you to keep your fingers, elbows and shoulders moving (as appropriate) to prevent stiffness, and your arm raised above your heart level to prevent swelling. At their direction, they’ll also have you start moving your wrist. They may refer you to a physical therapist to help regain your strength, function and motion.

Even after you’ve completed treatment, you may continue to experience achiness or stiffness. It can take six to 12 months for full comfort, strength and flexibility to return.

When should I see my healthcare provider?

If you’ve injured your wrist and think you may have a broken bone, you should seek medical treatment. If your injury isn’t that painful and no bones are noticeably out of place, you may be able to wait a day. In the meantime, you can protect your wrist with a splint. Apply ice and elevate it until you can see your provider.

If your injury is very painful or you have a noticeable deformity, you should get a ride to your provider’s office or an urgent care center right away.

What questions should I ask my healthcare provider?

Questions about your broken wrist you may want to ask your provider include:

• What kind of wrist fracture do I have?
• What treatment do you recommend for a broken wrist?
• What can I do at home to help with the pain?
• When can I start using my wrist again?
• How can I prevent future wrist fractures?

A note from Cleveland Clinic

Ouch! You’ve taken a bad fall, and now your wrist is swollen and painful. You may have a wrist fracture (a broken wrist). It’s important to get yourself to your healthcare provider or an urgent care center as soon as possible. A provider can help determine what kind of fracture you have and how to treat it. The road to recovery can take some time, but with appropriate treatment, you can make sure you heal properly and avoid complications.