What Kinds of Wrist Injuries are Possible?
A wrist injury such as a fracture requires medical care
- The wrist is made up of the two bones of the forearm (the radius and ulna) and eight carpal bones (scaphoid or navicular, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and the hamate). Many ligaments connect these bones to each other.
- A sprain is an injury to the wrist ligaments without any evidence of bone injury (that is, no broken bones or cracks in the bone). A strain is where there is a tearing of the muscle fibers in the area surrounding the wrist.
- With a sprain, there is usually only a partial tearing of the ligaments.
- In a severe wrist sprain, there can be a complete tear.
- A wrist fracture or broken wrist means there is a break or a crack in one or more of the bones of the wrist.
Wrist Injury Causes
The most common cause of wrist injuries is a fall on an outstretched hand.
- You can also have wrist pain from repetitive use that results in an inflammation of the tendons (tendonitis). This is termed a repetitive motion injury and is really not a true sprain.
- Carpal tunnel syndrome is another common wrist injury that may occur from repetitive motion.
Wrist Injury Symptoms
The amount of pain or the ability to move the wrist does not reliably determine whether the wrist is broken or sprained. Signs and symptoms of wrist injury include the following:
- Limited ability to move the joint
When to Seek Medical Care
If you have severe pain, deformity, numbness, or are unable to move your wrist, you should call your doctor for an immediate appointment, go to an urgent care clinic, or go to a hospital's emergency department.
If there is no deformity and the pain is manageable with over-the-counter pain medication, you may want to wait 12-24 hours before deciding whether to call the doctor. If symptoms persist after a day, see a doctor.
If you have obvious deformity, numbness, or severe pain, you need medical attention.
- If there is obvious deformity or severe swelling, there may be a broken bone that needs to be moved back into its normal position.
- There also can be a dislocation where the bones are no longer in the correct position, although they are not broken.
Exams and Tests
- The doctor will ask what happened. Sometimes the way you fell (the mechanism of injury) tells what type of injuries to look for. After taking a history, the doctor will examine the entire arm from the shoulder to the fingers. This is done to make sure there are no other injured areas. The doctor will also check to see how well the blood is flowing into the fingers and make sure there is no numbness in your hand.
- When examining around the wrist, the doctor will gently push on the wrist to determine where there is tenderness. A special area that will be examined is called the anatomical snuffbox. This is the area that is indented on the thumb side of the wrist when you stick your thumb up as if to hitchhike. Tenderness there is of special importance because the bone under that spot (the scaphoid) is the most common carpal bone that is fractured and often does not look fractured on the initial X-rays.
Anatomical snuffbox (see arrow): Under this area lies the scaphoid bone that is commonly broken, but the break may not show up on the initial X-rays.
Photo courtesy of Edmond A. Hooker, MD, FAAEM
X-rays of the wrist or forearm or both may be taken.
Wrist Injury Treatment
When you have fallen and injured your wrist, it is important to rest your arm.
- If there is an obvious deformity of the wrist or numbness in the hand, you should lay your wrist across a soft pillow and seek medical attention immediately.
- If there is no obvious deformity and you are not in severe pain, you may want to take some acetaminophen (such as Tylenol) or ibuprofen (Advil) and wait to see how the wrist feels. Again, a soft pillow is a good temporary splint.
- Apply ice to the area. Do not put ice directly on your skin. You can wrap a bag of frozen vegetables in a towel to create an icepack.
- If pain or other symptoms do not go away within a day, you should see a doctor.
Follow the doctor's instructions. Most of the time you should follow up if you are not completely better in three to five days, or sooner if you become worse or problems develop.
Wrist Injury Prevention
Follow the doctor's instructions. Most of the time you should follow up with your health care provider if you are not completely better in three to five days, sooner if you become worse or problems develop.
Wrist Injury Prognosis (Outlook)
- Most wrist sprains should be better in three to five days. If you have symptoms that last beyond five days, you should see your doctor for reevaluation.
- The outcome of a fracture depends on the type of fracture. Ask your doctor about what to expect for your type of fracture.
Wrist Injury and Fracture Pictures
Bones of the wrist: There are two long bones of the forearm (radius on the same side as the thumb and the ulna on the side of the little finger). There are eight small carpal bones that are between the forearm and the bones of the hand. Photo courtesy of Edmond A. Hooker, MD, FAAEM
Anatomical snuffbox (see arrow): Under this area lies the scaphoid bone that is commonly broken, but the break may not show up on the initial X-rays. Photo courtesy of Edmond A. Hooker, MD, FAAEM
The carpal tunnel is found in the _____________.