The wrist consists of the two forearm bones, the radius and the ulna, and the smaller carpal bones. Although there are eight carpal bones, fractures at the wrist typically involve the scaphoid and the lunate bones. The medical terminology for wrist fractures is a “distal radius fracture” which refers to a fracture of the radius near the wrist, but may or may not actually include a fracture that goes into the wrist joint. The wrist is surrounded by three nerves (median, radial, ulnar), two arteries (ulnar and radial) and many ligaments and tendons. All of these associated structures are at risk of injury either during or after an injury.
Distal radius fractures are some of the most common broken bones in all age groups. The break usually happens when someone falls and lands on an outstretched hand. Signs of injury include pain, swelling, bruising, and tingling in the hand and fingers. The diagnosis must be made by a medical professional, and x-rays will be ordered to evaluate the extent of injury. Fractures have different “personalities” depending on the location and the extent of the injury.
The best treatment for distal radius fractures depends on the specifics of the injury and is best determined by an orthopaedic or hand surgeon. In many cases, the fracture can be treated with a splint, brace or cast. Often, especially in children, the fracture can be re-aligned and treated in a cast or splint. However, sometimes surgery is required to hold fractures stable or piece together very severe fractures. Typically this will require a splint or cast for a few weeks or months after surgery.
Rehabilitation and physical therapy play a critical part in your recovery either after surgery or with non-operative treatment. In the early recovery period, physical therapy exercises are prescribed to decrease pain and swelling and to maintain wrist range of motion. It is very important to participate in therapy as your physician prescribes to avoid stiffness and limited motion. As you progress with your therapy, strengthening and special training exercises can also be incorporated. Exercises should be performed in a supervised setting, as well as at home on your own time. Your commitment to rehabilitation is key to a successful outcome.