Wrist fractures are one of the most common upper extremity fractures and tend to be one of the least forgiving. The wrist is comprised of 8 bones which articulate with the 2 forearm bones (the radius and the ulna). The most common wrist fracture site is the end of the radius, known as a distal radius fracture. Distal radius fractures often occur from a fall on an outstretched hand (FOOSH). There are several types of distal radius fractures (Colles, Smith, Barton, and Chauffeur) depending on the exact location of the break. The most common is the Colles fracture which occurs following a direct impact to the palm of the hand.
Symptoms and treatment for a wrist fracture
Immediately following a distal radius fracture, pain and swelling to the area will develop, followed by bruising. Your wrist may appear deformed/angulated and will require immediate medical attention. Diagnosis of the fracture will be confirmed with an x-ray. After the x-ray is taken, the medical team will try to reduce the fracture to restore anatomical alignment without surgery. This is important to ensure the bones are properly aligned and minimize stress on the surrounding soft tissue. From this point, there are two possible scenarios:
If the fracture is stable, meaning alignment has been achieved, no surgery will be required and a cast will be applied. Most times, the cast will be worn for 4-6 weeks depending on fracture healing.
If the fracture is not stable, surgery will be scheduled. Surgery might involve placement of pins, screws or plate and screws to ensure the fracture remains stable and healing takes place. Following surgery, a temporary cast will be applied and worn for about 2 weeks or until follow up with the surgeon occurs. A removable orthosis will then be worn for 4-6 weeks afterwards.
Hand physiotherapy for wrist fracture
While in the cast, it is important to keep your shoulder, elbow and fingers moving to prevent joint stiffness. After the cast is removed and your physician has approved physiotherapy treatment, it is most critical to book an appointment with a hand therapist to work on getting back range of motion, strength, and function. Wrist proprioception is also important to focus on, due to the numerous ligaments that support the wrist. Post-surgical swelling and scars will also be managed by your hand therapist. Get back to what matters most to you and book your appointment today with our expert hand therapists in Edmonton!
Reference
Naughton, N, Algar, L. (2021). Therapy Management of Distal Radius Fractures. Rehabilitation of the Hand and Upper extremity (7th edition, Volume 1, pages 833 – 850). Philadelphia: Elsevier, Inc.