Broken Wrist

Broken Wrist

Article by John Miller

Fractured Wrist

Broken Wrist

Common wrist fractures include:

  • Fractured Radius (see image)
  • Fractured Ulna
  • Colles Fracture (# Radius + # Ulna)
  • Fractured Carpals
    • Scaphoid Fracture (most common)
    • Lunate Fracture / Kienbock Disease
    • Capitate Fracture
    • Trapezium Fracture
    • Trapezoid Fracture
    • Triquetrum Fracture
    • Hamate Fracture
    • Pisiform Fracture

broken wrist

Each wrist fracture (broken wrist) needs specific rehabilitation based on injury type and fracture stability. Unstable fractures will almost always require surgical stabilisation. Stable fractures will be treated with a protective and supportive splint and monitored for appropriate fracture healing. If they show signs of instability, then your surgeon may consider operative stabilisation.

It is crucial only to perform the exercises prescribed by your Orthopaedic Surgeon or Physiotherapist. You should also wear your wrist splint/cast at all times unless advised otherwise by your physiotherapist or surgeon.

6 Weeks Post-Fracture General Guidelines

  • Splint/Cast. Do NOT remove the splint or bandage unless instructed.
  • No movement of the wrist. No AROM, PROM or Strengthening.
  • Physiotherapy for the wrist will commence once your fracture is stable and the cast is removed. Your surgeon will advise.
  • Restrictions: No lifting, pulling, pushing or weight-bearing for six weeks.
  • No driving for six weeks. You are not insured!
  • You may type, write and feed yourself with a lightly loaded fork.
  • No sports or activities where you are at risk of falling onto your wrist.
  • You will begin active (AROM) and passive (PROM) of the fingers to prevent stiffness, reduce swelling and avoid Chronic Regional Pain Syndrome (CRPS). Move your elbow and fingers through their full range of motion 10x/hour. These must be performed in the splint.
  • Vitamin C reduces the prevalence of CRPS after wrist fractures. A daily dose of 500 mg for fifty days is recommended. (Aïm et al. 2017)
  • Your surgeon may re-Xray weekly to ensure that the fracture is healing correctly. In some cases, they may recommend surgery to stabilise the fracture if it is not healing appropriately.

Hand Swelling, Pain or Pins & Needles

Important

Each radius fracture (broken wrist) needs specific rehabilitation based on the injury type and fracture stability. Unstable fractures will almost always require surgical stabilisation. Stable fractures will be treated with a protective and supportive splint and monitored for appropriate fracture healing. If they show signs of instability, then your surgeon may consider operative stabilisation.

General Advice: First 6-Weeks Post-Fracture

The following advice is general. Your trusted healthcare professional will specifically guide you.

  • Splint/Cast. Do NOT remove the splint or bandage unless instructed.
  • No movement of the wrist. No AROM, PROM or Strengthening.
  • Physiotherapy for the wrist will commence once your fracture is stable and the cast is removed. Your surgeon will advise.
  • Restrictions: No lifting, pulling, pushing or weight-bearing for 6 weeks.
  • No driving for 6 weeks. You are not insured!
  • You may type, write and feed yourself with a lightly loaded fork.
  • No sports or activities where you are at risk of falling onto your wrist.
  • You will begin active (AROM) and passive (PROM) of the fingers to prevent stiffness, reduce swelling and avoid Chronic Regional Pain Syndrome (CRPS). Move your elbow and fingers through their full range of motion 10x/hour. These must be performed in the splint.
  • Vitamin C reduces the prevalence of CRPS after wrist fractures. A daily dose of 500 mg for fifty days is recommended. (Aïm et al 2017)
  • Your surgeon may re-Xray weekly to ensure that the fracture is healing correctly. In some cases, they may recommend surgery to stabilise the fracture if it is not healing appropriately.

Beware of CRPS (Chronic Regional Pain Syndrome)

Hand Swelling, Pain or Pins & Needles

It is extremely important to prevent hand and finger swelling post-fracture. Near permanent elevation (high arm sling) and regular finger and upper arm movement while protecting the fracture is the key. CRPS is a very significant and painful complication that can complicate your rehabilitation. Carpal tunnel syndrome may present as pins and needles to your hand. Please report any increase in swelling, pins and needles, or pain to your physiotherapist or doctor ASAP.

Post-Fracture Exercises

Post-fracture exercises are specific to your fracture and should be performed after assessment and guidance from your healthcare professional. Based on that, it is imperative only to perform the exercises prescribed by your Orthopaedic Surgeon or Physiotherapist. You should also wear your wrist split/cast at all times unless advised otherwise by your physiotherapist or surgeon.

Do your exercises frequently throughout the day. Multiple sessions of short duration are generally better than longer sessions done only once or twice.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.

Tenderness

If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  

Swelling

Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.

Weakness

Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.

Arm Pain Causes

Arm pain and injuries are widespread. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.

Arm pain can be a local injury, musculoskeletal injury or could even be referred from nerves in your neck (cervical radiculopathy). This can result in neck-arm pain.

Causes of Arm Pain by Region

Causes of Arm Pain by Structure

Neck-Related Arm Pain

Shoulder-Related Arm Pain

Elbow-Related Arm Pain

Wrist-Related Arm Pain

Hand-Related Arm Pain

Muscle-Related Arm Pain

Other Sources of Arm Pain

Common Causes of Arm Pain

The most common sources of arm pain include shoulder painwrist pain and elbow pain.

Referred Arm Pain

As mentioned earlier, arm pain can be referred to from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).

Professional assessment from a health practitioner skilled in diagnosing both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.

Arm Pain has Diverse Causes.

The causes of your arm pain can be extensive and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.

What Arm Pain is Associated with a Heart Attack?

Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.

For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.

Good News. Most Arm Pain is NOT Life-Threatening.

Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.

Arm Pain Prognosis

The good news is that arm pain, and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.

Common Arm Pain Treatments

With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care, allowing you to resume pain-free and normal activities of daily living quickly.

Please ask your physiotherapist for their professional treatment advice.