A fracture near the wrist
A distal radius fracture is a break in the forearm bone on the thumb side, close to the wrist joint. A fall onto an outstretched hand can cause this injury. The break may leave the bone aligned, shift the fragments, or extend into the joint surface. Each pattern has implications for stability and treatment.
Pain and swelling after a fall need an examination. The wrist may look bent or feel too painful to use. Bruising can develop as the injury evolves. A fracture can occur alongside an injury to the ulna, wrist ligaments, or nerves. The assessment therefore includes the hand and forearm as well as the painful area at the wrist.
Urgent assessment after an injury
A wrist injury with an open wound, cold fingers, or worsening numbness requires urgent care. Severe pain that increases despite support also needs immediate attention. Remove rings early if they slide off easily, because swelling can make removal difficult. Support the wrist in a comfortable position while arranging assessment.
Avoid attempting to straighten an injured wrist yourself. A clinician checks the skin, circulation, sensation, and finger movement before deciding how to stabilize the injury. Tell the team how the fall happened and whether you struck your head or injured another body part. This history helps ensure that the wrist receives care within the context of the entire injury.
X-rays and fracture alignment
X-rays show the location of the break and the position of the fragments. The clinician evaluates the angle, length, and joint surface of the radius. Computed tomography may be used when a detailed view of a joint fracture is needed for planning. The appearance of the wrist alone cannot establish the full fracture pattern.
Treatment decisions combine imaging with your health and functional needs. Hand dominance, bone quality, work, and the ability to manage a cast all matter. Follow-up imaging may be needed because a fracture can shift during healing. Ask what the initial images show, how stable the fracture appears, and which changes would lead to a different treatment recommendation.
Reduction, splinting, and casting
A fracture with acceptable alignment may heal with a splint or cast. When the fragments have shifted, a clinician may perform a reduction to improve their position. Pain control is part of that procedure. A splint can accommodate swelling, with the support adjusted as the wrist changes during early healing.
Cast care protects the skin and the fracture. Keep the cast dry and follow instructions for finger movement and elevation. Increasing tightness, new tingling, or a change in finger color should prompt contact with the treating team. Putting objects inside a cast can damage the skin. Follow-up visits allow the clinician to check fit, alignment, and progress toward bone healing.
Surgical fixation
Surgery may be recommended when alignment or stability cannot be maintained with external support, or when the fracture pattern requires direct repair. A plate and screws, pins, or an external frame can hold the fragments while the bone heals. The choice depends on the injury and the surrounding tissues.
Fixation supports the fracture during healing; activity still needs to follow the surgeon's limits. Risks include infection, nerve or tendon irritation, stiffness, loss of alignment, and hardware-related problems. An injury involving the joint can lead to arthritis later. Discuss which motions are allowed, how the incision will be cared for, and whether hand therapy is part of the plan.
Motion, strength, and bone health
Restoring wrist function requires both bone healing and recovery of soft-tissue movement. Finger, elbow, and shoulder exercises may be prescribed while the wrist is protected. Wrist motion and strengthening begin when the treating clinician considers them appropriate. The schedule depends on fracture stability, treatment, and follow-up findings.
A fracture from a low-energy fall can be a reason to assess bone health and fall risk. Ask whether bone density evaluation or a review of medications and balance is appropriate. Before returning to driving, lifting, or sport, confirm the required level of healing and control. Recovery planning should account for everyday needs such as dressing, preparing food, and safely getting around your home.
Tell the treating team if you live alone or rely on a walking aid. These details can affect the support you need while an injured wrist is protected.
Further reading: AAOS: Distal radius fracture guidance