Have you just fractured your wrist and you have so many questions about treatment and recovery. You are at the right place.
I will base this article on my knowledge as a diagnostic radiographer and scientific studies to answer some of your questions.
Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏
Last updated: April 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
Basics
When you break your wrist, it means you have broken one of the small (carpal bones) in the wrist joint or more the distal radius which is the larger of the two bones that make up the forearm.
This bone most often breaks at the lower end, near where it connects to the bones of the hand and thumb.
▶️What are the different 4 types of wrist fractures?
There are 4 types of common wrist fractures, and all of them can be damaged, either individually or simultaneously.
1️⃣ Colles’ fracture (distal radius with dorsal displacement of fragments).
2️⃣Smith’s fracture (distal radius with volar displacement of fragments).
3️⃣Scaphoid fracture.
3️⃣Barton’s fracture (fracture dislocation of the radiocarpal joint).
What is the most common fracture in the wrist?
Of all the four types, the most common type of wrist fracture I see in x-ray is the Colles (distal radius) fracture.
I think the radius is the most common fractured bone in the body.
▶️How do you know you have a fractured wrist?
I believe you have had a fall probably on an outstretched hand (FOOSH) or because of your age you might have osteoporosis which might have caused your wrist to fracture.
Generally, when you go to an emergency department. The doctor will:
Ask you questions to understand how the injury occurred and your current symptoms will be assessed.
Usually, patients I see in x-ray they come in with severe pain that might worsen when gripping or squeezing or moving the hand or wrist, swelling, tenderness and bruising.
You will be sent to have x-rays to determine if you really have a fracture or something else.
Usually, x-ray is enough to determine if you have had a fractured wrist, any further imaging like CT, ULTRASOUND OR MRI will be used in more complex distal radius fractures, particularly for operative planning, however this can be performed once initial management steps have been made.
▶️Management / Treatment options of wrist fractures.
The correct diagnosis and management of these fractures is crucial, as incorrect management may result in loss of normal wrist function, with significant implications on functional status and quality of life.
Conservative option.
The conservative management for nondisplaced wrist fractures involves wrist immobilisation in a splint or plaster cast for 5 weeks.
Stable wrist fracture on the left and on the right a plaster cast is applied to help with healing.
If your fracture is stable, you will likely be given a splint to keep your wrist from moving as healing takes place. You will likely wear a splint for 3 to 5 weeks.
If you go through surgery, you will be given a cast which you will wear for 5 to 6 weeks.
Most patients I have seen state complete healing between 6 to 12 weeks after they have received treatment.
It’s normal to have aches and discomfort beyond this. This often happens when you try activities you haven’t done for a while.
It’s also normal for the area to be more sensitive for several months after the injury.
Surgical option
If your fracture is displaced or unstable surgical intervention will be the best option, as they have a risk of displacing further over time if not stabilised.
Of course, you will be given general anaesthetic during the operation and you will not feel pain during the procedure.
Depending on the type of fracture you have got open reduction and internal fixation (ORIF) with plating is usually used. A plate and screws are inserted at the fracture site, or K-wire fixation which is used more often in children’s fractures.
Images of wrist fracture after surgery
Then your wrist will be placed in a cast to ensure ongoing immobility. It usually takes about six weeks for your bone to heal and another six weeks for the bone to be almost as strong as it was before.
A recent meta-analysis showed that although surgical treatment does provide a better radiological outcome, no significant differences in functional outcome or complication could be found between operative and conservative treatments. (Song,2015)
However, a recent Network Meta-analysis concluded, that plate fixation offers the best results in terms of early functional outcome and reduction of fracture healing complications (Vannabouathong,2015)
▶️What are recovery tips for a fractured wrist?
Rehabilitation and recovery will depend on a few things.
Duration of immobilisation must be adapted to the patient’s needs and compliance to the post-surgical restrictions.
Post-operative rehabilitation is important for wrist management after treatment due to the wrist joint involvement.
Once your clinical team agrees it is safe for you to use and move your wrist, your cast will be removed.
When your cast is first removed it is normal to feel pain as your hand has not moved for some weeks.
Your rehabilitation and your commonly asked questions.
▶️What is the healing time for a broken wrist in adults?
Here is table that breaks down the stages and the estimated recovery time of a wrist fracture, whether its displaced or not.
| stage | Healing time (range) |
| Less pain | A few days to a few weeks |
| Bone Healing is complete | 6 weeks to 3 months (much less for kids) |
| Swelling & bruising to go away | A few days to weeks |
| Cast and mobilisation off | 6 weeks to 3 months |
| Gradual return for hand function like dressing | A few weeks to a few months |
| Using your hand to carry a bag or using weight | 2 to 5 months |
| Resuming all your normal activities such as sports, work | 3 to 8 months |
▶️Can you move your wrist if it’s broken?
When you have had a fractured wrist try not to move your wrist until you receive medical care, you can support it with a supporting sheet under the wrist to keep it in one position.
However, after you have received treatment, you are only encouraged to use the injured hand for light daily activities like eating from the first day after surgery.
It is also ok to actively move your wrist and forearm as frequently as possible after the cast has been taken off.
The NHS here in the UK, encourages simple wrist movement exercises you can do at home to help reduce pain, swelling and help with the healing process.
It is important to start wrist exercises as soon as the cast is removed.
It is well known that physiotherapy is beneficial in restoring mobility to wrist fractures but the impact of supervised physiotherapy and active wrist exercises after surgery of wrist fractures operatively is still not fully clarified in the literature.
Several studies investigating additional supervised physiotherapy versus a prescribed home exercise programme showed no conclusive evidence that upper limb function really benefited with the supervised treatment compared to a sole home exercising programme. (Valdes, 2015).
To be honest I have seen patients not going through physical therapy after their cast was taken off and they have recovered well without any problems.
My own husband had surgery for a broken wrist and only simple home exercises helped him in the process of healing.
So, it is up to you to seek physical therapy if you think you need one or follow your doctors’ instructions.
▶️How do you know if a broken wrist is not healing even after surgery?
I have seen patients complain of tenderness, swelling and aching pain even after months of treatment.
Some scientific studies state that the main complications following distal wrist fractures that can lead to delayed healing even after surgery could be:
Malunion, whereby poor realignment of bones can lead to a shortened radius compared to the ulnar, leading to reduced wrist motion, wrist pain, and reduced forearm rotation.
Nerve compression, more common in patients who heal in a significant degree of malunion.
Osteoarthritis, especially with intra-articular involvement from the original fracture
Symptoms of a fracture that is not healing normally include tenderness, swelling, and an aching pain that may be felt deep within the affected bone.
Often, the bone isn’t strong enough to bear weight, and you may not be able to use the affected body part until the bone heals.
Usually when you experience these symptoms after weeks of treatment, please see your doctor for examinations.
These could be signs that your wrist fracture might not be healing well.
▶️What happens if you leave a broken wrist untreated?
When a wrist fracture is untreated, it can result in either a non-union or delayed union where the bone does not heal at all which means it will remain broken.
As a result, swelling, tenderness, and pain will continue to worsen over time.
So, it is very important to seek medical attention if you think you have fractured your wrist.
▶️Do wrist fractures ever fully heal?
The good news is most people with wrist fractures I have seen recover fully after treatment.
During my years of practice, I have seen so many wrist fractures and the patients recover fully and are able to return to their normal activities.
▶️To help you speed up the healing of a broken wrist.
🟢Elevate Your Wrist. To reduce swelling and pain, raise your wrist so it’s above your heart.
🟢You can apply Ice. To help reduce swelling.
🟢Use Pain-Relieving Medication prescribed by your doctor.
🟢Exercise Joints Near the Wrist.
🟢Keep Your Cast Dry.
🟢When your cast is first removed without surgery, soak your wrist in warm water and moisturise to help with dry skin.
🟢Work With a Physical Therapist if advised.
🟢Visit Your Doctor for a Follow-Up.
Getting back to your normal exercise level is very important. There are no restrictions on walking or running, although the hand can swell up if you do a lot quickly.
▶️How do you sleep with a broken wrist?
Patients claim that it is often hard to sleep the first night after a wrist is broken.
Try to put several pillows underneath your arm to keep it elevated or elevate the wrist above your heart to minimise how much blood flows to your heart and minimise the pain.
▶️Should I wear a wrist brace after cast removal?
You should have been given a removable splint when your cast was removed.
Continue to wear this at night and for protection in busy environments, such as on public transport.
▶️What should you not do after cast removal?
The casted area may be tender for a few weeks and the skin dry.
You should avoid jumping, climbing, running or activities with a high risk of falling for a period after the cast is removed.
▶️How long are you off work with a broken wrist?
The length of absence may vary slightly depending on the specific circumstances of the injury and the individual’s healing process.
However, this general range of 8-12 weeks provides an estimate of the time needed for recovery and rehabilitation following surgery for a wrist fracture.
▶️Why is my broken wrist throbbing?
If your wrist starts to hurt or swell long after a break, see your doctor for an evaluation.
It could be nerve or blood vessel damage. Trauma to the wrist can injure adjacent nerves and blood vessels.
Seek immediate attention if you have numbness or circulation problems!
▶️Should a broken wrist still hurt after 4 weeks?
After a wrist fracture, most of the healing happens between 6 to 12 weeks.
It’s normal to have aches and discomfort beyond this. This often happens when you try activities you haven’t done for a while.
It’s also normal for the area to be more sensitive for several months after the injury.
▶️Why does my broken wrist feel warm?
The increase in blood flow around the fracture during the healing process increases the temperature of the surrounding tissue.
Infrared thermography is a method of measuring body temperature that can detect temperature changes during bone healing.
▶️Can I drive with a broken wrist in a cast?
It is best to wait for complete bone healing, which usually occurs 4 to 6 weeks after the fracture before resuming activities like driving and cycling.
Patients are normally advised to not to drive in a plaster. A plaster cast or splint will reduce your range of movement.
Here in the United Kingdom, there are driving instructions after you have fractured a bone.
You can be fined up to £1,000 if you don’t tell DVLA about a fracture that affects your driving. You may be prosecuted if you’re involved in an accident as a result.
This is what I wanted to tell you about wrist fractures. I hope I have given you some reassurance, I wish you a quick recovery.🙋
Below are some of the articles I have relied on for this article.
📚SOURCES
Quadlbauer S, Pezzei C, Jurkowitsch J, Rosenauer R, Kohlmayr B, Keuchel T, Simon D, Beer T, Hausner T, Leixnering M. Rehabilitation after distal radius fractures: is there a need for immobilisation and physiotherapy? Arch Orthop Trauma Surg. 2020 May;140(5):651-663. doi: 10.1007/s00402-020-03367-w. Epub 2020 Mar 19. PMID: 32193679.
Song J, Yu A-X, Li Z-H (2015) Comparison of conservative and operative treatment for distal radius fracture: a metaanalysis of randomised controlled trials. Int J Clin Exp Med 8:17023–17035 25.
Vannabouathong C, Hussain N, Guerra-Farfan E, Bhandari M (2019) Interventions for distal radius fractures. J Am Acad Orthop Surg 27:e596–e605. https://doi.org/10.5435/JAAOS-D-18-00424 26.
Le ZS, Kan SL, Su LX, Wang B (2015) Meta-analysis for dorsally displaced distal radius fracture fixation: Volar locking plate versus percutaneous Kirschner wires. J Orthop Surg Res. https:// doi.org/10.1186/s13018-015-0252-2 27.
Valdes K, Naughton N, Burke CJ (2015) Therapist-supervised hand therapy versus home therapy with therapist instruction following distal radius fracture. J Hand Surg Am 40:1110–6.e1. https ://doi.org/10.1016/j.jhsa.2015.01.036
Kay S, McMahon M, Stiller K (2008) An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised trial. Aust J Physiother 54:253–259