Broken Wrist: Symptoms, Types, Causes and Treatment

A broken wrist, also known as a wrist fracture, is one of the most common bone injuries affecting both children and adults. Whether caused by a simple fall, sports mishap, or more severe trauma, a broken wrist can disrupt daily activities and, if not properly managed, may lead to long-term complications. Understanding the symptoms, types, causes, and treatment options is essential for effective recovery and prevention of future injuries. This article provides a comprehensive, evidence-based overview of broken wrists, synthesizing current research to offer clear guidance for patients, caregivers, and anyone interested in musculoskeletal health.

Symptoms of Broken Wrist

Recognizing the symptoms of a broken wrist is the first step toward timely diagnosis and treatment. While pain is the hallmark symptom, fractures can present with a variety of signs depending on the type and severity of the break. Early recognition can help prevent complications such as nerve damage, deformity, or long-term loss of function.

Symptom	Description	Typical Population	Source
Pain	Immediate, often severe, wrist pain	All ages	3 4 5 6
Swelling	Noticeable swelling around the joint	All ages	3 4 6
Deformity	Visible change in wrist shape	Adults, children	4 6 7
Bruising	Discoloration at the injury site	All ages	4 6
Tenderness	Sensitivity to touch over the wrist	All ages	3 4 6
Reduced Motion	Limited ability to move the wrist	Adults, children	6 8
Numbness	Tingling or numb sensation, especially if nerve is involved	Adults	1 2 6

Table 1: Key Symptoms

Understanding the Symptoms

A wrist fracture seldom goes unnoticed, but the specific symptoms can vary.

Pain and Swelling

• Pain is usually immediate and significant, especially when trying to move or use the hand. The pain may worsen if pressure is applied to the wrist or when attempting to grip objects 3 4 5 6.
• Swelling tends to develop quickly around the wrist, sometimes spreading into the hand or forearm 3 4 6.

Deformity and Bruising

• A deformed appearance—such as a bent or crooked wrist—often indicates a displaced fracture 4 6 7.
• Bruising may appear within hours of the injury due to bleeding beneath the skin 4 6.

Tenderness and Reduced Motion

• Tenderness is often present over the fracture site, particularly when pressing on the wrist bones 3 4 6.
• Reduced range of motion is common, as moving the wrist becomes painful or physically impossible due to the break 6 8.

Numbness and Nerve Involvement

• In some cases, especially with complex fractures or severe swelling, numbness or tingling may occur. This can signal nerve compression, particularly of the median nerve, and requires prompt attention 1 2 6.

Types of Broken Wrist

Wrist fractures are not all the same. Several distinct types exist, each with unique features, causes, and treatment implications. Understanding the fracture type is crucial for selecting the best treatment pathway and predicting recovery outcomes.

Fracture Type	Main Feature	Common Age Group	Source
Distal Radius (Colles’)	Break near wrist end of radius; dorsal displacement	Adults, elderly	5 6 7
Smith's Fracture	Volar (palmar) displacement	Adults	9
Barton's Fracture	Intra-articular fracture-dislocation	Adults	9
Torus/Buckle Fracture	Cortex bulges, no full break	Children	10
Perilunate Fracture-Dislocation	Dislocation with complex ligament/bone injury	Adults	1 2
Trapezial Ridge Fracture	Fracture at base of the thumb	All ages	3

Table 2: Types of Wrist Fractures

Overview of Wrist Fracture Types

Distal Radius Fractures

• Colles’ fractures are the most common type, especially in older adults, with the wrist bending backward (dorsal displacement) 5 6 7.
• Smith’s fractures are less common, featuring the wrist bending forward (volar displacement) 9.
• Barton's fractures involve a break that extends into the wrist joint and may include dislocation (fracture-dislocation), posing a higher risk of instability 9.

Pediatric Fractures

• Torus (buckle) fractures are typical in children. The bone compresses but does not fully break, often resulting from a fall onto the hand 10.

Complex and Unusual Fractures

• Perilunate fracture-dislocations involve both bone and ligament injuries, caused by high-energy trauma. These are complex and often require surgical intervention 1 2.
• Trapezial ridge fractures occur at the base of the thumb and may be missed unless special imaging is used. These can cause pain at the base of the thenar eminence (thumb muscle) 3.

Causes of Broken Wrist

A broken wrist can happen suddenly or as a result of underlying health conditions. Knowing the causes helps identify those most at risk and can guide prevention strategies.

Cause	Description	At-Risk Group	Source
Fall from Standing	Falls onto an outstretched hand	Elderly, children	5 10
High-Energy Trauma	Sports, vehicle accidents, workplace injuries	Adults	1 2 5
Osteoporosis	Weakened bones prone to fracture	Older adults, women	5
Repetitive Impact	Recurrent stress or overuse	Athletes	5
Lifestyle Factors	Smoking, drinking, obesity	All ages	5

Table 3: Common Causes of Wrist Fractures

Exploring the Main Causes

Falls

• Falls from standing height are the leading cause, particularly among older adults and women due to decreased bone density 5. Children also commonly experience wrist fractures after falls during play or sports 10.

High-Energy Trauma

• High-impact injuries—such as car or motorcycle accidents, sports collisions, or workplace incidents—are more likely to cause complex fractures, including perilunate dislocations and multiple bone injuries 1 2 5.

Bone Health and Medical Conditions

• Osteoporosis is a significant risk factor, as weakened bones are more susceptible to breaking even from minor trauma. Prevalence increases with age, particularly in postmenopausal women 5.

Lifestyle and Demographic Factors

• Obesity, frequent alcohol consumption, and smoking have all been linked to an increased risk of wrist fractures, either by affecting bone strength or increasing the likelihood of falls 5.

Repetitive Stress

• While less common than acute trauma, repetitive impact from certain sports or occupational activities can weaken or micro-fracture the bones, eventually leading to a break 5.

Treatment of Broken Wrist

Treatment options for a broken wrist vary widely depending on the type of fracture, patient age, severity, and any associated injuries. Proper management is key to restoring function and minimizing long-term complications.

Treatment	Indication	Main Advantage	Source
Immobilization	Stable/simple fractures	Non-invasive, effective	6 7 10
Cast/Splint	Most common for children/adults	Standard care	6 7 10
External Fixation	Unstable/distal radius fractures	Maintains alignment	7
Open Reduction & Internal Fixation	Complex, displaced, or perilunate fractures	Anatomical repair	1 2 9
Physical Therapy	Post-immobilization/surgery	Restores movement/strength	8
Home Exercise	Rehabilitation after fixation	Convenient, effective	8

Table 4: Common Treatments for Wrist Fractures

Treatment Pathways Explained

Immobilization

• Casting and Splinting: The majority of stable wrist fractures, especially in children (such as torus fractures), are treated with casts or splints to immobilize the wrist and allow the bone to heal. Recent research has shown that even a soft bandage may be as effective as a rigid cast for simple torus fractures in children 10.
• Conservative Management: Many distal radius fractures in adults can also be managed non-surgically, though some may lead to deformity or reduced grip strength if not properly aligned 6 7.

Surgical Options

• External Fixation: For unstable or displaced wrist fractures, especially dorsally displaced distal radius fractures, external fixation can prevent redisplacement and provides better anatomical outcomes than casting. However, it carries a higher risk of minor complications (like pin track infections) 7.
• Open Reduction and Internal Fixation (ORIF): Complex fractures such as perilunate dislocations, Barton's, and Smith's fractures often require surgery to realign the bones and repair ligaments. This may involve plates, screws, or K-wires. Prompt surgery improves alignment and may reduce long-term complications, although some loss of motion or pain can persist 1 2 9.

Rehabilitation

• Physical Therapy and Home Exercise: After immobilization or surgery, regaining movement and strength is essential. Home exercise programs have been shown to be as effective, if not more so, than supervised physiotherapy for restoring function after internal fixation 8.
• Monitoring for Complications: Long-term follow-up is important, as some patients may experience decreased grip strength, persistent pain, or complications such as nerve compression (particularly of the median nerve) 6.

Conclusion

A broken wrist is a common injury with a wide range of presentations, causes, and treatment options. Early recognition and appropriate management are essential for optimal recovery and prevention of complications. Here are the main points to remember:

• Symptoms include pain, swelling, deformity, bruising, tenderness, reduced motion, and sometimes numbness [1-6].
• Types of wrist fractures include distal radius (Colles', Smith's, Barton's), torus (buckle) fractures in children, perilunate fracture-dislocations, and rare types like trapezial ridge fractures [1-3,5-10].
• Causes are most often falls (especially in elderly and children), high-energy trauma, osteoporosis, and lifestyle factors like smoking, drinking, and obesity 1 2 5 10.
• Treatment options range from simple immobilization in a cast or splint to advanced surgical repair, with rehabilitation—either supervised or home-based—being vital for regaining function [1,2,6-10].

By understanding the symptoms, types, causes, and modern treatment strategies, patients and caregivers can make informed decisions and support optimal recovery from this common but potentially serious injury.