Many everyday accidents can cause a wrist fracture. There are plenty of opportunities for this to happen, since we constantly use our hands to pick up, move, or set down objects… and also to break our fall.
Falls are the most common cause of wrist or hand fractures. If a fall is not broken properly, the injury can occur upon impact with the ground or due to compression. It is not recommended to try to reset a dislocated finger on your own. It is best to see a doctor if there is an obvious problem.
Types of Wrist, Hand, and Finger Fractures
There are various types of wrist and hand fractures. If you fall with a clenched fist or deliver a violent blow with your hand, the bones in the palm (metacarpals) may be affected. Fractures of the distal phalanx (the one where the fingernail grows) are common, but they often heal on their own within a few weeks. This is because the fingernail, which covers a large part of the phalanx, acts as a sort of splint to stabilize the fractured bone, facilitating healing. In adults, one of the most common fractures involves the wrist—or, more specifically, the bones of the forearm, the radius and the ulna. It is strongly recommended to seek medical attention if the wrist or hand appears unusual or “twisted.” In such cases, it is likely that a bone has been displaced.
Diagnosis: Clinical Examination and X-ray
The examination by a doctor includes an inspection (appearance of the injury), palpation, and finally an X-ray. Further testing is rarely necessary, but it may be required to refine the diagnosis in cases of complicated injuries (e.g., displaced bones, bone fragments).
Treatment: Immobilization or Surgery?
Most often, the fracture is classified as closed, and treatment involves immobilizing the affected bone or bones to allow them to heal in the correct angle or position. This is known as the conservative approach. The techniques used vary: sometimes the fractured fingers are simply taped together; other times, a rigid cast is applied. These measures rarely last longer than a month. The patient is advised to keep their wrist or hand at rest during this time to avoid complications that could prolong rehabilitation.
Some unstable fractures require orthopedic treatment involving immobilization with a cast or resin for four to six weeks, depending on the severity of the injury. It is important to immobilize the joints above and below the fractured bone. In summary, if the displacement of the bone or bones is not too significant, conservative management is generally sufficient. Otherwise, surgical treatment should be considered.
There are several types of techniques and materials available to surgically stabilize a wrist or hand fracture caused by trauma such as a fall or impact. For example, plates and pins (screws) can be inserted—which are either removed or left in place once the injury has healed—or an external fixator can be used (a metal frame mounted on the outside of the limb and attached to the fracture site by rods that pass through the skin). The benefit of this approach is that it prevents the fractured bone or bones from coming into direct contact with the surgical hardware. This is the option often chosen to minimize the risk of infection in cases of open fractures, when there is significant skin damage and the tissues may have been contaminated. An open fracture always requires prompt surgical intervention to prevent infection.
Anatomy of the Wrist and Hand
It should be noted that the wrist and hand consist of 27 bones, including 8 carpal bones, 5 metacarpal bones, and 14 phalanges, which together ensure their flexibility and range of motion. In addition, there are numerous ligamentous and tendinous structures that provide lateral stability, not to mention the muscles essential for strength. All of this explains the wide variety of wrist and hand fractures.
We remind you that the specialists at the Sports Medicine Center at Hôpital de La Tour are available to assist you if you wish to receive treatment for this condition.
Frequently Asked Questions
Does a wrist fracture always require surgery?
No. In most cases, immobilization with a cast or splint is sufficient. Surgery is considered when the bone displacement is too severe or in the case of an open fracture.
How long do you have to wear a cast after a wrist fracture?
Generally, a few weeks, up to four to six weeks for unstable fractures treated orthopedically.
How can you tell if you’ve fractured your wrist after a fall?
A “twisted” or unusual appearance of the wrist or hand should be a warning sign and prompt you to seek medical attention quickly, as it suggests bone displacement.
Why is an open fracture more serious?
Because the associated skin damage exposes the bone to a risk of infection, which requires prompt surgical treatment.