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What are hand and wrist fractures?

When any of the hand’s long bones (metacarpals) or short bones (phalanges) are broken, it is called a hand fracture. A hand fracture is an injury associated with athletes who participate in contact sports (including soccer, rugby and football) and winter sports (snowboarding and skiing).

A broken wrist (distal radius fracture) is a break in one or more of the bones that connect your forearm to your hand. Wrist fractures can range from a small, hairline crack to a bone or bones broken into two or more pieces.

Hand and wrist fractures are especially common in the elderly, especially those with osteoporosis. Osteoporosis is a disease that affects primarily postmenopausal women and some men over the age of 50. When men and women age, bone mass density declines, making them more susceptible to fractures. They are also more prone to falling.

Most hand and wrist injuries are preventable, yet they are among the most common bone fractures. It is very important to seek immediate medical intervention and care if you think you have suffered a hand or wrist fracture. 

Symptoms

Different types of hand and wrist fractures have somewhat different symptoms, since they occur in different locations, but they are generalizable. If you sustain a fracture, your hand or wrist will hurt, bruise, swell and weaken. Additionally, your range of motion will be reduced, and you will likely not be able to grab things. The following are common symptoms:

  • Pain
  • Bruising
  • Swelling
  • Weakening
  • Reduced range of motion
  • The inability to grab

The symptoms of hand and wrist fractures may be mistaken for the symptoms of other medical conditions, such as sprains and strains. Make sure you consult a doctor to determine if you have a fracture and get the appropriate treatment. 

Causes

Hand and wrist fractures are generally the result of a fall or a blow to the hand. The following are some common causes:

  • Falling on an outstretched hand or wrist—When you catch yourself with one hand after a fall, you are putting a lot of stress on your bones. If it is a hard fall, or if your bones are weakened (for example, by osteoporosis), you are vulnerable to fractures.
  • A blow to the hand or wrist—If you receive a blow to your hand or wrist, you may sustain a fracture. If the fingers are not balled up, they are also quite vulnerable to fracture.
  • Twisting the hand or wrist—If your hand is twisted, as can happen in sports, the bones of your hands and/or wrists can be overstressed and fracture.    

How are they diagnosed?

Hand and wrist fractures can make daily living difficult and cause lasting effects if not treated properly. If you think your wrist has been broken either completely or partially, it is important to seek medical attention. To diagnose your injury, your doctor will ask questions about your trauma and perform a physical exam. These tests  typically are done to determine the exact location and severity of the breakage:

  • X-ray (radiograph)—This is the initial test done to look for a break in the bone. It is done by sending electromagnetic radiation through the hand and wrist area, which produces images of your musculoskeletal structure.
  • Computed tomography scan (CT or CAT scan)—A CAT scan is a combination of computers and radiograph imaging and is used to determine if there are smaller pieces from the fracture or dislocations of the wrist bone.
  • Magnetic resonance imaging (MRI)—MRIs do not use radiation, unlike X-rays and CAT scans. Instead, you are put in a tube containing a magnetic field. Then, radio waves are directed at the hand and wrist, causing them to vibrate. These vibrations are then translated into a computer-generated image.

Treatment options

Nonsurgical treatment

A wrist fracture is one of the easiest types of bone breakages to treat without surgery. Typically, a casting method is used to immobilize the bone while it heals. In some cases, the wrist may have come out of alignment when it broke; when this happens, the doctor may use local anesthesia to realign the wrist and put it on the right track for healing.

If a hand fracture is minor, it can be treated with a nonsurgical approach. If the fingers are damaged, they may be placed in a finger splint so that the rest of the hand can remain mobile while the finger repairs; if other bones are damaged, they may require a cast or splint to stabilize the injured portion of the hand while the bones heal from the breakage. Antibiotics and painkillers may be given to help reduce the risk of infection and ease the pain from the trauma.

Surgical treatment

In some cases, especially when the bones have shifted out of normal position, a wrist fracture will require surgery. The aim of most wrist fracture surgeries is to help guide the bones back into place and hold them while the bone fragments heal.

Hand fractures can also require surgery in severe cases. The goal of most hand fracture surgeries is to reconnect the bones and hold them in place so they do not cause any permanent deformities.

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