Have you broken your wrist? (Wrist Fracture) Let's talk about this!

Oh, do you ever get a bad wrist injury when you fall? Or have you ever hit your hand while playing sports, and now the area is swollen, blue, and in so much pain that you can't even move it? Then you may have a broken wrist, which means a broken bone (fracture) . Don't be scared when you hear this, because this happens to many people. Today, we will talk in detail and simply about a broken wrist, or as doctors call it, a ``Wrist Fracture''.

What does it mean to break the wrist of this hand?

Simply put, a ``Wrist Fracture`` is a break in the wrist joint or one or more of the bones that are associated with it. There are about ten bones in our hand, from the wrist to the base of the palm. Any one of these can break. The main bones are:

• Radius: This is the largest bone in your forearm, on the side of your big toe.
• `Ulna` (ulna bone): This is the small bone in the forearm, on the side of the little finger.
• Carpal bones: These are eight small bones located inside the wrist joint, at the beginning of your hand.

Of these , the most common fracture is the part of the ``Radius`` bone closest to the wrist. Doctors also call this a ``Distal radius fracture``.

Types of wrist fractures

There are several different types of wrist fractures. These are classified according to the pattern of the fracture. Here are some of the main types:

• Colles fracture: This is the most common type. If you fall with your arm outstretched and your palm facing the ground, your wrist can bend backwards, causing this type of fracture. This is where the broken end of the radius bone is pushed upwards, towards the back of your hand.
• `Smith fracture`: This occurs when the arm is bent forward and the back of the hand hits the ground. Here, the broken end of the `(Radius)` bone is pushed downward, that is, towards the palm.

In addition to these two main types, doctors classify these fractures in other ways:

• Intra-articular fracture: If the bone breaks and the fracture line goes inside the wrist joint, it belongs to this type.
• Extra-articular fracture: This is where the bone breaks, but the fracture line does not go inside the joint.
• `Open fracture`: This is a bit dangerous. Because here the bone breaks, the skin is pierced and protrudes. Then there is a high chance of germs entering through the wound and causing an infection. If something like this happens, you need to go to the hospital immediately.
• `Comminuted fracture`: Here, the bone breaks into several pieces, rather than in one place.

How common are wrist fractures?

This is actually more common than you might think. For example, in the United States alone, more than 450,000 fractures are reported each year. Of these, about 1 in 6 fractures is a ``Distal radius fracture``, that is, a fracture of the ``Radius`` bone in the wrist that we talked about earlier. This situation may be similar in Sri Lanka, because falls and accidents happen a lot.

How do you know for sure if your wrist is broken? (Symptoms)

If you have a broken wrist, you may experience one or more of these symptoms:

• Severe and persistent pain: This is the main symptom. The pain can be so severe that you can't even move your arm.
• Swelling: The area around the broken arm is very swollen.
• Tenderness: If you touch or press on the fractured area, it causes unbearable pain.
• Bruising: Sometimes the skin around the broken bone may turn blue or purple.
• Stiffness of the hand: It becomes difficult to bend or straighten the hand at the wrist.
• Hand deformity: Sometimes the broken part of the hand may appear stretched or bent unnaturally. Some people say it looks like the hand is "crooked."
• Tingling in the fingertips: Some people may feel like their fingertips are tingling.

Important: If you have these symptoms, don't just assume, "It will get better on its own." Definitely see a doctor and get checked out.

Why do wrists break like this? (Reasons)

Most often, a wrist fracture occurs when the arm falls outstretched, or when the hand hits the ground or a wall. Then the weight of the entire body falls on the arm, and the bone can break in the wrist. Imagine, falling while trying to catch a ball while playing cricket, or slipping in the bathroom, or falling off a bicycle... This can happen at any time.

The causes of wrist fractures in young people and those over 60 are slightly different.

• Young people: A young person's wrist fracture is usually caused by a high-energy incident . For example, a fall from a height, such as a ladder, a car accident, or a hard fall or collision while playing sports.
• People over 60: A wrist fracture in this age group is not necessarily a major accident. It can happen from a low-energy incident. For example, a slight slip and fall while standing can cause this. The main reason for this is that bones lose strength as we age.

What are the risk factors? (Risk Factors)

Some people are more at risk of breaking their wrists than others. This is especially true for people with a condition called osteoporosis . Osteoporosis is a condition in which bones become weak and easily breakable.

There are several other risk factors among people over 60 years of age:

• Decreased bone mineral density (Osteopenia): This is a precursor to Osteoporosis.
• Being a woman: Women are at higher risk than men.
• Being white: (This is a fact stated according to international data.)
• Having a family history of such fractures.
• Early menopause.

What are the complications of this condition?

If not treated properly, sometimes a wrist fracture can lead to various complications. These include:

• A tendon rupture in the hand.
• Carpal tunnel syndrome: A condition that causes numbness and pain in the hand due to compression of a nerve that passes through the wrist.
• Compartment syndrome: A serious condition in which swelling impairs blood flow to the tissues of the arm and increases pressure.
• Complex regional pain syndrome: A condition that causes persistent severe pain and swelling.
• Arthritis of the wrist: Over time, arthritis of the joint can develop.

This is why it is said that if you suspect you have a broken arm, you should see a doctor immediately.

How does a doctor diagnose this?

When you go to a doctor, he or she will first ask you how it happened and what your symptoms are. Then he or she will carefully examine your hand, bending it from side to side (a `physical examination`).

But to know exactly if there is a fracture, where it is, and how serious it is , you definitely need to get an `X-ray` (X-ray) test. Sometimes, in addition to the fracture, the doctor may also recommend a `CT scan` (CT scan) or `MRI scan` (MRI scan) to see if there is damage to the `ligaments` (ligaments), `tendons` (tendons), and `nerves` (`spinal cords` ) in the hand.

What is the treatment for this?

The treatment for a broken wrist depends on a number of factors, including:

• Breakage type: Types like `Colles` and `Smith` that we talked about earlier.
• Severity of the fracture: Whether the bone is slightly cracked, or broken into pieces, or whether it has pierced the skin and protruded.
• Whether there are other injuries: Sometimes, a blood vessel or nerve may be damaged along with the bone fracture.
• Your age, how active you are, and whether this is your dominant hand also play a role.

The first step in treatment is to put the broken bone back in place. Then, the bone must be immobilized until it heals, preventing it from moving again.

• If the bone fragments are in place: The doctor may immediately apply a plaster cast (a `cast`) to the bone until it heals.
• If the bone fragments are out of place: The doctor will then have to set the bone fragments back into place. This is called a `reduction` .

`Closed reduction` (treatment that does not cut the skin)

This is a non-surgical procedure. This means that the doctor will not cut your skin, but will simply align the bone fragments on the outside. Then, they will put on a splint or cast to hold the bone fragments in place. A splint is usually worn for a few days to allow the swelling to subside. A cast is usually worn after a few days or a week (when the swelling has subsided). The cast may need to be changed as the swelling subsides.

Your doctor will take X-rays weekly to monitor your healing, for at least three weeks. Then, they will take another X-ray in about six weeks. At that time, the cast will often be removed and you will be instructed to begin physical therapy to improve your hand's function and motion. You may also be instructed to wear a splint for a while to protect your wrist.

`Open reduction` (surgical repair)

This is a surgical procedure. Sometimes the closed reduction method doesn't work. The doctor will have to make an incision in the wrist and realign the bones. Then, they will use one or more of these methods to hold the bones together until they heal:

• `Cast` (plaster)
• `Plate and screws`: The bone pieces are put together, a metal plate is placed on top, and screws are used to secure them.
• `Metal frame with pins`
• `External fixator`: This involves inserting pins into the bones and attaching them to an external frame. This frame holds the bones together until they heal from the inside.

How long does it take for a wrist sprain to heal?

The time it takes for a wrist fracture to heal depends on a number of factors, including the severity of the fracture and the type of treatment.

• Closed reduction: You will be in a splint for a few days, followed by a cast for four to six weeks. After that, it may take three months or more to return to your normal activities.
• Open reduction (surgical repair): This method takes a little longer to heal.

During your recovery, your doctor will tell you to move your fingers, elbows, and shoulders (as much as possible) to prevent stiffness in your arm. They will also tell you to keep your arm elevated above your heart to reduce swelling. Your doctor will also tell you to start moving your wrists. You may also be referred to a physical therapist to help you regain strength, function, and range of motion.

Even after all the treatments are finished, you may still feel some pain or stiffness. It can take six to twelve months to regain full comfort, strength, and flexibility. So be patient with your treatments.

Can you prevent wrist fractures?

Most wrist fractures are caused by falls and accidents, so they are difficult to prevent. However, maintaining good bone health, especially for those over 60, can help reduce this risk. If you have a condition like osteoporosis, talk to your doctor about what you can do to keep your bones strong. A balanced diet, calcium, vitamin D, and exercise can help.

When should I see a doctor?

If you have an injury to your wrist or think you have a broken bone, you should definitely seek medical attention.

• If the injury isn't too painful and doesn't look like the bone is sticking out, you can probably wait a day or so before seeing a doctor. In the meantime, protect your wrist with a splint. Apply ice and keep your arm elevated.
• However, if the wound is very painful, or if the shape of the hand is clearly changed (like it has been pulled), you should immediately go to a doctor or an emergency room with someone. Don't delay.

What questions should I ask the doctor?

If you have a broken wrist, it's a good idea to ask your doctor questions like these:

• What kind of wrist fracture do I have?
• What is the best treatment for this?
• What can I do at home to reduce pain?
• When will I be able to use my arm again?
• What should I do to prevent these kinds of breaks in the future?

Finally, take-home message

Oh, it's normal to feel scared when you fall and your wrist hurts and swells. But remember, you're not alone.

The most important thing is to seek medical advice as soon as possible. A doctor can tell you exactly what type of fracture you have and what the best treatment is for it.

The healing process may take some time, but with proper treatment and physical therapy as prescribed by your doctor, you will be able to use your arm as you used to, and you will be able to avoid complications. So, stay strong and patient with your treatment!

` Wrist fracture, hand fracture, wrist fracture, Colles fracture, Smith fracture, wrist pain