The radius, one of the two large bones of the forearm; and the carpus, come together in the radiocarpal or wrist joint. The joint contains distal parts of forearm bones and proximal parts of the five metacarpal bones. Thus, the wrist joint is not just a single joint but it involves a number of joints. Therefore, broken wrist may indicate breaking of one single bone or it may involve breaking of more than one bones.
To avoid confusion, broken carpal bones are referred to as carpal fractures, and breaking of the distal part of the radius and / or ulna (another bone in the forearm) is recognized as a wrist fracture. About 75% of wrist fractures show fractures of the distal radius and ulna. Scaphoid is the carpal bone near the radius. There are chances of breaking the scaphoid bone during a wrist injury.
Overuse of the wrist joint can lead to broken wrist. Certain sports like cricket, certain occupations (for example, a carpenter has to perform repeated movements) involve continuous and repetitive movements of the wrist joint or excessive pressure on wrist joint. A motor vehicle accident is the most common cause of fractured wrist. If someone falls on a hard surface, and while falling, he / she falls on the wrist in extension (outstretched arms), then the bones in the wrist are likely to break. This type of fracture is known as Colles' fracture.
If someone falls with flexed wrists, he / she will break the wrist, but the type or site of fracture would be different. This type of fracture is known as Smith's fracture or reverse Colles' fracture. People who suffer from osteoporosis (low calcium density) or bone cancer, are more susceptible to bone fractures.
Severe pain in the wrist joint is obviously one of the most common wrist fracture symptoms. The person may experience excruciating pain when flexing the wrist. Tenderness, bruising, swelling around the joint, and deformity of the joint (crooked and bent wrist), suggest bone fracture. Some patients may experience numbness of the hand, wrist or even the arm. The fingers may look pale.
When the median nerve gets compressed, numbness in the hand can be experienced. This is known as carpal tunnel syndrome. The patient may not be able to move the forearm as well as the hand. In a distal fracture of the radius, fracture of the ulnar styloid is also noticed in about 60% of cases. In some fractures, the skin is intact (closed fracture), while in some, open wounds increase the risk of infection (open fractures). Displacement of the wrist and hand is noticed in severe injuries.
Diagnosis and Treatment
Applying ice on the broken wrist, taking painkillers, keeping the wrist elevated on a pillow, etc., help relieve the pain and swelling at the start. Several sets of X-rays might be required for wrist pain diagnosis. An X-ray helps find out whether the fracture gap is small or wide, whether the bone has broken down into two pieces or into a number of pieces (comminuted fracture), whether the fragments are completely separated or are partially joined, or whether the fragmented pieces are driven into one another.
Torn ligaments can also be detected through a proper examination. A CT-scan can be ordered to check the exact nature of the fracture and damaged parts. In case of severe injuries, light sedation or local anesthesia is used during resetting of the bones. A small surgery might be required to realign the broken wrist. Plates, screws, splint, and a cast can be used to treat the broken wrist. The person is often required to undergo physiotherapy.
The recovery time may vary according to the severity of the fracture symptoms. It might take two to six months to get back into proper activity. If the bones of the wrist are not joined perfectly (like a jigsaw puzzle), the person may suffer from arthritis, stiffness of the joint, and pain. A person with a fractured wrist should provide complete rest to the affected area. He / she needs to follow the instructions of the doctor religiously, and needs to see the doctor immediately if the symptoms worsen after the treatment.