What is a Broken Wrist?
A broken wrist is fracture of any of the wrist bones or the ends of the forearm bones (radius and ulna).
Many times, it is the result of a fall on an outstretched hand.
Quickcare or ER?
The Red Flags that will take you to the ER are:
- severe pain
- skin discoloration
- gross deformity
If the skin is open near the wound, be careful. An open fracture needs an orthopaedic doctor and antibiotics.
Falls happen so fast. Adrenaline is pumping. After a few deep breaths, then we can isolate the problems.
Your doctor will want to know your symptoms. A SYMPTOM is your description of your condition to your doctor. It is your story.
Doctors are going to ask how bad is the pain?
What makes it better? Ice? Pain pills?
What makes the pain worse? Movement? Touching it?
Is there anything associated with the pain such as numbness ?
What will doctor look for?
Your doctor will look for signs. A SIGN is an objective finding discovered during the examination.
Does the wrist look deformed ?
How does the skin look? Bleeding from the skin at the area of a broken bone (an open fracture) is very bad and requires a surgeon.
What is the Doctor Thinking
Of course, broken bones( fracture) need to be considered. There are many types
Lets look at the bones of the wrist.
The break could be in the forearms (Radius and Ulna) which is called a Colles Fracture.
The wrist bones (Carpals)
or the hand itself (metacarpals)
or Could all of this be a sprain? That is, no broken bones.
One important wrist exam is the snuff box. The wrist bone that lies here (Scaphoid) is so unique. Why? The blood goes from the farthest part to the nearest So if there is a break, there is a greater chance that the bone will die (necrosis).
What is the treatment of a wrist fracture?
If it is a small chip-type fracture, then a splint and cast will be fine.
If there is a gross deformity, a bone doctor (orthopaedic) needs either to push it back into place or do a surgery placing plates and screws.
How long will you be sick?
Most broken bones heal up in 6-8 weeks. Sometimes, physical therapy will be needed to strengthen muscles once the cast is removed
You can’t always see a broken wrist on xray. The wrist bones (carpals) can be tricky. That is why a splint is placed often even if there is nothing obviously broken. The splint will provide support.
Also, who knows? Maybe the xray doctor will report a broken bone a few days after you were already gone.
That is why a splint is put on and a recheck xray 2 weeks later in common. Within those two weeks then a fracture probably will be visible.
Let me tell you a story
Ol’ Grandma was getting wobbly on her feet. Every time she walked, she would sway something fierce. “You gonna fall” was heard around her almost as much as “What’s for dinner?” Finally it happened. Her foot got caught on a rug. She tried to protect her new dentures by sticking out her outstretched arm. Her face was fine but she came to me holding on to her wrist. Of course all of her family was convinced she had a broken wrist. When I see someone her age fall, I always ask if other things hurt like the head and neck. A biggie are the hips. You have to ask specifically if the hips hurt.
Ol’ Grandma came up with only her wrist hurting.
In Ol’ Grandma’s case, she had an isolated wrist pain that was local, sharp severe with no associated numbness. There was worsening of the pain with movement
Unfortunately, she had a Colle’s fracture on xray. The orthopaedic doctor was called to re-align the bones.
After a long 2 months, she gradually was able to do her house chores without help from the grandkids.
I hope this helps
David Reyes MD