Wrist Fracture (Broken Wrist, Scaphoid Fracture, Colles' Fracture)

Definition

A wrist fracture is a break in one or more of the bones in the wrist. The wrist is made up of the two bones in the forearm (radius and ulna) and eight carpal bones. The carpal bones connect the end of the forearm bones with the bases of the fingers.

Colles' fracture—A break near the end of the radius, an arm bone that forms part of the wrist joint. This fracture is common in older people, and much less common in children and adolescents.

Scaphoid fracture—A break in the scaphoid, a bone located on the thumb side of the wrist where it meets the radius. This fracture is most common in young, active people. The scaphoid bone is also sometimes called the navicular.

Causes

A wrist fracture is caused by trauma to the bones in the wrist. Trauma may be caused by:

• Falling on an outstretched arm
• Direct blow to the wrist
• Severe twist of the wrist

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury.

Risk factors include:

• For Colles' Fracture:
  
  • Advancing age
  • Postmenopause
  • Decreased muscle mass
  • Osteoporosis
  • Poor nutrition

• For Scaphoid Fracture:
  
  • Participating in contact sports, such as football or soccer
  • Participating in activities, such as inline skating, skateboarding, or bike riding
  • Participating in any activity which could cause you to fall on your outstretched hand

• For either:
  
  • Violence or high-velocity trauma such as an automobile accident

Symptoms

Symptoms include:

• Pain
• Swelling and tenderness around the wrist
• Bruising around the wrist
• Limited range of wrist or thumb motion
• Visible deformity in the wrist

Diagnosis

The doctor will ask about your symptoms, physical activity, and how the injury occurred, and will examine the injured area.

Tests may include:

• X-rays—to look for a break in the wrist bones
• MRI scan (rarely)—a test that uses a strong magnetic field and radio wave to detect a hidden scaphoid fracture
• CT scan (rarely)—a type of x-ray that uses a computer to detect unusual small fractures or dislocations of the wrist bones

Treatment

Treatment will depend on the severity of the injury. Treatment involves:

• Putting the pieces of the bone together, which may require anesthesia and/or surgery
• Keeping the pieces together while the bone heals itself

Devices that may be used to hold the bone in place while it heals include:

• A cast (may be used with or without surgery)
• A metal plate with screws (requires surgery)
• Screws alone (requires surgery)
• Metal pins that cross the bone, with a metal splint on the outside of the wrist that holds the pins and the fractured bone in place (requires surgery)

The doctor may prescribe pain medication depending upon the level of pain. Your doctor will order more x-rays while the bone heals to ensure that the bones have not shifted position.

Prevention

To help prevent a wrist fracture:

• Do not put yourself at risk for trauma to the wrist bones.
• Eat a diet rich in calcium and vitamin D .
• Build strong muscles to prevent falls and stay agile.
• Wear proper padding and safety equipment when participating in sports or activities.