Orthopaedic Conditons & Treatments

Wrist Fractures, Causes and Symptoms

Wrist fractures may be located in one of the two forearm bones, most commonly in the radius, or in one of the eight carpal bones. Although there are many different types of fracture that may occur in this area, such as scaphoid and ulna fractures, the term “wrist fracture” typically refers to breaks in the end of the radius bone. This is one of the most common types of broken bones, particularly in children, adolescents and adults under the age of 65. When adults reach the age of 65, weakened bones from osteoporosis make hip fractures the most common type of broken bone. Even with the high number of such fractures in elderly patients, however, a wrist fracture still accounts for 1 out of 6 cases of fracture reported in American emergency rooms.

Anatomy of the Wrist
The wrist may refer to the eight bones that form the carpus (the connecting point between the forearm and hand), or it may refer to the joint between the carpus and the radius (one of two long forearm bones), or it may refer to the area around the carpus. A distal radius fracture is most often referred to as a wrist fracture, because of the radius’ proximity to the wrist in the forearm, whereas a broken carpel bone is often referred to as a carpal fracture. There are technically 10 bones that form the wrist. The first two are the radius and ulna (the two long forearm bones) and then there are those eight carpal bones:  

  • Capitate
  • Hamate
  • Lunate
  • Pisiform
  • Scaphoid
  • Trapezium
  • Trapezoid
  • Triquetrum

In addition to the eight carpal bones that connect the forearm and the hand, there are also the distal ends of the ulna and radius (the two large forearm bones), and the proximal areas of the five metacarpal bones. If this complex network of bones and joints is not functioning properly, the mobility of the hand may be severely altered. The wrist bones make several very important hand movements possible:

  • Extending
  • Flexing
  • Pronating
  • Radial deviation   
  • Supinating
  • Ulnar deviation

Types of Wrist Fracture
There are many different types of wrist fractures, including radius or ulna fractures (the two long bones making up the forearm) and carpal fractures (the set of eight smaller bones making up the carpus). These wrist fractures are further divided into several subcategories, including the following:

  • Radius or Ulna Fractures
    • Chauffeur’s Fracture: This is a break in the styloid process contained in the radius.
    • Colles’ Fracture: This radius injury is the most common type of wrist fracture, in which the wrist bends at an upward angle.
    • Galeazzi’s Fracture: This is a breakage in the radius that leads to a dislocated ulna.
    • Monteggia's Fracture: This is a breakage within the ulna that leads to a dislocated radius. 
    • Smith’s Fracture: This radius injury is marked by a downward-bending wrist, the opposite of the formation of the Colles’ Fractures.
  • Carpal Fractures
    • Triquetral Fracture (break in the triquetrum bone)
    • Scaphoid Fracture (break in the scaphoid bone)
    • Lunate Fracture (any fracture involving the lunate bone)
    • Lunate Dislocation (any dislocation involving the lunate bone)
    • Perilunate Dislocation (when the capitate bone dislocates from the lunate bone)

Causes of Wrist Fracture
Serious impacts to the wrists or hands can cause wrist fractures in which any number of bones may be broken. These are some of the most common wrist fracture causes:

  • Serious Falls: A person has to fall in just the right way, with their hand stretched out, to break their wrist or hand. Since it is often one’s natural instinct to outstretch the hand to avoid serious impact to the rest of the body, this is one of the most common wrist fracture causes.
  • Sports-Related Injuries: Wrist fractures are also often the result of contact sports or recreational activities that put you at risk of falling with your hand stretched out. Sports such as football, basketball and baseball commonly cause finger fractures, whereas individual sports such as snowboarding and rollerblading more commonly cause fractures to the wrist during accidental falls.  
  • Vehicle Crashes: Some of the most serious fractures of all types occur during vehicle accidents, particularly at high speeds. Such high-velocity injuries can result in multiple fractures to the wrist and surrounding areas, in addition to injuries in other parts of the body. This type of fracture more often requires surgery.   

Symptoms of Wrist Fracture
The most common wrist fracture symptoms include the following:

  • Decreased mobility of the hand and wrist
  • Deformed bones in the wrist area
  • Severe pain in the wrist and/or surrounding areas
  • Swelling of the wrist

If you have injured your wrist and feel any sort of pain in this area, it’s important to seek medical treatment, even if the pain does not seem intense enough to be a fracture. Everyone experiences wrist fracture symptoms differently, and every injury requires an individualized treatment plan to ensure successful rehabilitation. Only with careful review of x-ray images by a trained medical professional can you truly tell whether the wrist is broken, and whether the fracture is stable or unstable, in which case surgery may be required. In most cases, however, a cast can be used to treat stable wrist fractures, and medical professionals can often reset an unstable fractured wrist while the patient is sedated or while local anesthesia has been applied.      

All wrist fractures are different. Several factors will determine the most appropriate course of action for each specific patient, such as:

  • Age
  • Activity level
  • Physical demands
  • Bone quality
  • Fracture location
  • Type and severity of bone displacement

A physician can assess whether non-surgical treatments such as casting and resetting could be or have been successful, and whether surgery will be required to reposition the bones. With immediate medical treatment from trained professionals and ongoing maintenance, however, full rehabilitation is possible for most wrist fractures.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York treats Wrist Fractures as well as a broad range of conditions that affect the bones within the body.

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