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Wrist Fractures (Broken Wrist)

This page has been designed to provide you with the right information about wrist fractures and how to manage them from a physiotherapy point of view.

What is a wrist fracture?   

Firstly, a fracture is the same as a break. The word fracture is a medical term and a break is more of a common term to describe an injury to a bone that has caused it to break. For the remainder of this information page, we will use the term fracture.

There are many different types of fractures regardless of this; they all essentially mean the same thing i.e. that one or more of the bones in your wrist joint have been broken.

I’ve heard it called a Colles fracture, is that the same thing?

As mentioned above, there are a number of different types of fracture and they each have their own name. A Colles fracture relates to a break in a bone called the radius as it meets your wrist joint. A Colles fracture is the most common type of wrist fracture.

Is it easy to fracture your wrist?

It really isn’t easy to break a bone in your body. Your bones are incredibly strong and can take an awful lot of knocks, bumps and injuries and will generally not complain. You are more likely to find that you may upset the soft tissues (ligaments, muscles and tendons) following an injury than your bones.

How would you fracture a wrist?

The most common way to fracture a wrist is by falling onto an outstretched hand. In general, if you fall you will instinctively put your hands out to protect your face. As your hand hits the floor, the force and energy created by the fall goes through your hand/ wrist, and if it's more than the wrist can cope with it may cause one or more of the bones to break.

Remember, it is very difficult to break a bone, therefore most of the time, an injury to your wrist would result in a sprained wrist (ligament injury) rather than a fracture.

 

What if I think I’ve actually broken my wrist?

If you have suffered an injury and your wrist is significantly swollen, perhaps has changed shape, is very painful and you simply cannot move it properly, you should seek help via A&E.

 

If I go to hospital, what will they do?

Often, a diagnosis can be made by asking some special questions and carrying out a physical examination (if available). However, if the hospital suspects you may have fractured your wrist, then they will arrange an X-ray to check your bones.

What if they find that I’ve broken my wrist, what will happen?

If you have been to the hospital and an X-ray has revealed that you have fractured your wrist, then normally you will be asked to see a specialist orthopaedic (bone and joint specialist) doctor to discuss your options.

Normally, the two options are non-surgical or surgical management.

Can wrist fractures be managed without surgery?

Yes, indeed. However, the orthopaedic doctor and their team will decide with you what the best option for you might be. Certain types of fractures can be managed more easily without surgery and some types of fractures do better with the help that surgery offers.

What can I expect when the plaster comes off?

For most people, the plaster cast is likely to be kept on for between 4-6 weeks.

You will normally be seen or spoken to by the hospital before removing the cast. Sometimes, you will have another X-ray to check the progress of your wrist but this is not always the case.

If you have had your cast off, it is really important for you to know what is normal as we understand it can sometimes be a worrying time.

So, is my wrist healed now?

Fractures typically heal within about 6-8 weeks. There are things that might influence this, such as any pre-existing health conditions like diabetes or if you smoke, but typically once you pass the 6-8 week timescale you can consider your wrist healed.

Unfortunately, just because the fracture itself might be healed (a higher level of healing goes on for several months but you won’t be aware of this), does not mean that any pain will stop or the movement will come back by itself. This is where rehabilitation and physiotherapy can help.

Can I break it again by using it?

Your bones were strong before the fracture and they will still be strong now after the fracture. Your wrist may be sore and you may find that your confidence to use it normally might have been affected since the break, but it is not fragile and it is not vulnerable.

By exercising your wrist and doing normal daily things, you can help the healing process even more which will help you get a better result overall.

 

Can I expect my wrist to go back to exactly how it was before I broke it?

This is a really good question. Once you have broken a bone, especially if it is close to a joint, you have effectively changed its anatomy. With this in mind, you may find that after a fracture, your wrist may not be able to go back to everything you did before or do things in the way you did before 100%. The good news is that if you work hard, are patient and kind to yourself and give it the right amount of time, you will make the best recovery that you can.

 

Ok, what can I start doing to help my wrist get better?

 

Is there anything else I can do?

 

Is there anything I should look out for?

After a fracture or a period of time where your wrist hasn’t been able to move (in a plaster cast), it is important to look out for the following symptoms:

  • Redness, swelling and heat around the wrist, especially if accompanied by a fever or generally feeling unwell
  • Poor healing of your wound (only applicable if you have had an operation) – wet or oozing, especially if accompanied by a fever or feeling generally unwell
  • Gross levels of pain that is not easily controlled with pain relief.
  • Significant swelling of your arm (especially if pressing it leaves a finger mark)
  • Any of the above, especially if you have had a past history of Deep Vein Thrombosis (DVT)

If you have any concerns about any of the symptoms listed above, you should speak with your GP, 111 or seek help from A&E.

 

What exercises should I be doing to start with?

In the earliest stages of your recovery i.e. within the first few weeks, it is recommended that you simply try to gently move the wrist and fingers as well as you can and as far as is comfortable. We have provided a selection of suitable exercises below.

Frequently asked questions

 

A: It is not unusual to find that your wrist feels strange after an injury. It is normal to feel tight or stiff after a fracture of any kind, but these things often ease with time and some gentle exercises.

A: Swelling can sometimes be the last thing to settle after injuries. It can sometimes hang around for weeks into months after the injury however, if you are feeling better, moving better and doing more, it is not something you should be worried about.

A: Again, this is something that can be fairly common after a wrist fracture. If you managed to injure your wrist after a fall or an accident, it can sometimes be that your shoulder may have been upset at the same time. Sometimes, as the pain settles with the wrist you can find that the issues with the shoulder start to come to the surface.

You can find some excellent guidance and exercises for common shoulder problems here: Shoulder Pain

A: It is likely that you will not be able to return to driving for at least 6 weeks after your injury. It is each individual’s responsibility to ensure they are fit to drive. As well as making sure you are in full control of the vehicle at all times, you should ensure you can confidently and without any hesitation, perform an emergency stop before even considering driving on public roads.

It is always recommended to contact your insurance company one month before you return to driving to ensure your insurance is valid. This advice is the same if you drive an automatic car.

A: This will be dictated by your wrist and your sport. Most people will find their wrist feels better after a few weeks/ months. By working on the movement, strength and balance exercises, as well as being patient, you may find that going back to most sports by about 3 months will be successful (this can be very variable).

Exercise tip:

 

Movement exercises: You should try to complete these little and often throughout the day. Try to move your wrist as far as is comfortable.

 

Strength exercises: You should aim to complete the exercises (as many or as few as you want to) about 3 to 4 times a week.

Each exercise should be completed between 8-12 times (or repetitions) for 3 to 4 sets. Make sure you have about 1 minute's rest in between each set.

For the strengthening exercises, remember, in order to change your muscles you need to challenge them. In other words, you should really feel the effort with each set of exercises and should really not be able to do more than 12 each time around.

Download our blank gym programme here.

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