Hand and Wrist Fractures and Trauma | Orthopaedics | Loyola Medicine

Hand and Wrist Fractures and Trauma

Overview and Facts about Hand and Wrist Fractures and Trauma

The hands and wrists are made up of many different bones, muscles, and ligaments and are common sites for injury. A hand or wrist fracture is a break or crack in one or more of the bones in the hand or wrist. A fractured hand can affect the small bones of the fingers (phalanges) and the long bones within the palm (metacarpals). The wrist comprises eight small bones that connect with the two bones in the forearm, called the radius and ulna.

Signs and Symptoms of Hand and Wrist Fractures and Trauma

The most common bone to break in the wrist is the radius (an injury called a distal radius fracture), while the most common hand fracture is a fracture of the fifth metacarpal, the bone in the hand that supports the little finger. 

Hand and wrist fractures share many similar symptoms, including:

  • Severe pain that might worsen when gripping or squeezing something or when moving the hand or wrist
  • Swelling, tenderness and bruising
  • Obvious deformity, such as a bent wrist or crooked finger
  • Stiffness or inability to move the fingers or thumb
  • Numbness in the hand or fingers

Causes and Risk Factors of Hand and Wrist Fractures and Trauma

A direct blow or crushing injury can cause a fractured hand or wrist. Common causes include:

  • Falls — Falling onto an outstretched hand is one of the most common causes of a fracture, especially in a wrist.
  • Sports injuries — Hand and wrist fractures often occur during contact sports (such as football, rugby, and soccer) or recreational activities (which might include skateboarding, snowboarding, in-line skating or jumping on a trampoline).
  • Severe trauma — These include car accidents or occupational injuries (such as falling from a ladder).
  • Weak bones — Osteoporosis can weaken bones and lead to fractures.

Tests and Diagnosis of Hand and Wrist Fractures and Trauma

Hand and wrist fractures are typically diagnosed in emergency rooms. Doctors use X-rays to confirm diagnoses and to determine the number of broken bones and any displacement (gaps between broken bones).

MRIs and CT scans allow doctors to see fractures and other injuries (such as those to ligaments, tendons, muscles or nerves) more clearly.

Treatment and Care for Hand and Wrist Fractures and Trauma

Treatment for hand and wrist trauma depends on several factors, such as the type of injury and whether it involves displaced, unstable or open fractures.

If the broken ends of the bone are out of alignment, a physician must manipulate the pieces back into position in a procedure called a closed reduction. The patient must wear a cast or splint for a period of time to keep the fracture in place while it heals.

Complicated fractures, such as open fractures in which pieces of bone have broken through the skin, require surgery for reconstruction and realignment.