Your wrist may be fractured at the radius or the ulna, or at the carpal bones. Your doctor may reposition your broken bone by closed or open reduction. Reduction can be done for all types of fractures. However, treatment will vary for each fracture and depend on the extent of injury. Treatment may also include self-care, such as hand or wrist exercise, or a cast to prevent movement (immobilization).
The wrist may fracture at the end of the radius and sometimes at part of the ulna. This fracture often results from a sudden fall on an outstretched hand.
If the bones are in good position, treatment is simple: only a cast is needed. If the bones are out of place (dislocated), a closed or open reduction may be required.
Carpal Bone Fracture
Falling on your wrist can fracture any of the carpal bones. They can also be knocked out of place (dislocated). The most common carpal fracture involves the scaphoid bone. This bone forms a joint with the radius and 4 other carpal bones.
To prevent movement and allow healing, your hand and wrist may be put in a cast or other device for up to 4 months. Surgery may be needed for major carpal bone fractures or for fractures and don’t heal with other treatment.
Treatment: Closed and Open Reduction
In closed reduction, the fractured bones are “set” (put back into proper position) before the wrist and hand are put into a cast or splint. If the fracture is unstable, pins may be inserted after the bones are set to help keep them in place. A cast is needed for 6 to 8 weeks.
In open reduction, surgery is used to set bones that are fractured. Then pins, plates, or screws are inserted to hold the bones in place while they heal. A cast may be applied and worn for 6 to 8 weeks.
Your Role After Reduction
- Keep Hand Elevated
To reduce swelling and pain, keep your hand raised above your heart for as long as your doctor suggests. Also, move your shoulder in all directions to keep it from getting stiff.
- Move Fingers
To speed healing and restore function to your hand, you may be given finger exercises. They may hurt at first but will hurt less as you heal.
Call your doctor right away if you have:
- Increased pain
- A tingling feeling
- A change of color in your hand or fingers
Hand Fractures and Ligament Tears
Fractures of the bones and the fingers (phalanges) and in the body of the hand (metacarpals) are common. They can result from direct blows, trapped and twisted fingers, or crushing accidents. If a joint is forced to move beyond its normal range of motion, the ligament in the thumb is the most likely hand ligament to tear.
A direct blow from a heavy object such as a brick can break one or more of the bones in the finger.
If needed, bones are set by either closed or open reduction. Then the injured finger is splinted or may be put in a cast to prevent movement while healing. Sometimes the finger next to the injured one is also splinted (buddy splint) for added support.
Crushing blows can break the bones in the body of your hand. These bones may also break if the fingers are trapped and twisted.
A splint may be enough to ensure mending. If needed, open reduction may be done. Then a cast is put on. Depending on the extent of injury, one or more fingers may be splinted.
When fingers are jammed against something solid, the bony pints at the ends of the finger bones may break or chip. These fractures can result in a loss of finger function.
The fracture may need open or closed reduction. The finger will then be held in place by a splint or cast. Range-of-motion exercises may be started in 3 to 6 weeks.
A hard fall onto the thumb may fracture the metacarpal bone in the base of the thumb. The fracture may be made worse by the joint at the bottom of the thumb moving out of place. This joint is called the carpo-metacarpal joint. It is where the thumb meets the wrist. Ligaments may also tear.
If it is a simple fracture, closed reduction may be enough. For more complex fractures of those with torn ligament, open reduction and surgery may be needed. After reduction, the thumb is put in a cast for 5 to 8 weeks.