Wrist Fracture (Distal Radius Fracture)
A wrist fracture is one of the most common injuries treated in orthopaedics and typically involves a break in the distal radius – the larger of the two forearm bones, just above the wrist joint. It usually results from a fall onto an outstretched hand and causes pain, swelling, and difficulty using the wrist. Although many fractures heal well with plaster or splint treatment, others are displaced or unstable and may require surgical fixation to restore wrist alignment and function.
Common Symptoms
- Pain and swelling around the wrist after a fall or impact
- Visible deformity or change in wrist shape
- Difficulty moving or using the hand
- Bruising spreading into the hand or forearm
- Tenderness to touch over the wrist joint
Typical Causes
Most wrist fractures occur when someone falls onto an outstretched hand, especially when the wrist is extended. The injury is common in older adults with osteoporotic bone, but also affects younger people following high-energy trauma such as sports injuries, road traffic accidents, or falls from height.
Seek urgent help if
There is an obvious deformity, inability to move the fingers, severe swelling, open wounds, or numbness or tingling in the hand. These symptoms may indicate significant injury or nerve compromise and require immediate medical attention.
Call 999 for emergencies, or NHS 111 for urgent advice.
On this page:
Symptoms
A wrist fracture usually causes immediate pain, swelling, and loss of wrist movement. The wrist may appear bent or deformed, especially if the fracture is displaced. Bruising often develops within hours and may extend into the fingers. Patients typically struggle to grip or bear weight through the hand. In severe cases, tingling or numbness may occur if there is compression of the median nerve within the carpal tunnel.
The pattern of symptoms can vary depending on the type of fracture, ranging from hairline cracks (which may initially mimic a sprain) to more complex breaks involving the joint surface.
Causes / Risk Factors
The majority of wrist fractures are caused by a fall onto an outstretched hand (FOOSH). The nature of the injury depends on both the direction of the fall and bone quality.
Risk factors include:
- Osteoporosis (brittle bones) or low bone density
- High-impact sports (e.g. skiing, cycling, horse riding)
- Slips and falls on uneven or icy surfaces
- Reduced balance or coordination in older age
- Previous wrist injury or arthritis affecting joint stability
Children and adolescents may sustain similar injuries involving the growth plate (Salter–Harris fractures), while younger adults often experience more complex intra-articular fractures after higher-energy trauma.
Investigations & Diagnosis
Diagnosis begins with a thorough clinical assessment and plain X-rays of the wrist in at least two views. This confirms the fracture type, displacement, and whether the joint surface is involved.
Fractures are typically classified using an eponymous name system such as:
- Colles’ fracture (dorsally displaced, the most common pattern)
- Smith’s fracture (volarly displaced)
- Barton’s fracture (an intra-articular fracture with either the volar or dorsal cortex remaining intact)
- Die-punch fracture (involving the articular surface)
- Radial styloid fracture (isolated fragment at the radial / thumb side)
If the fracture is complex, comminuted, or extends into the joint, CT scanning may be performed to aid surgical planning. In selected cases, MRI can help identify associated soft tissue injuries, such as tears of the TFCC or scapholunate ligament.
Treatment Options
Non-surgical
Many wrist fractures can be treated conservatively if they are well aligned and stable:
- Plaster or splint immobilisation: typically worn for 4–6 weeks.
- Elevation and ice: to reduce swelling in the early phase.
- Physiotherapy and gentle mobilisation: once healing is confirmed on X-ray. During immobilisation, maintaining shoulder and finger movement is essential to prevent stiffness.
- Regular follow-up X-rays are important to ensure the fracture position remains satisfactory during healing.
Surgical
If the fracture is displaced, unstable, or involves the joint surface, surgical fixation may be required. Surgical options include:
- Open reduction and internal fixation (ORIF): using a low-profile volar plate and screws to restore alignment.
- K-wire fixation: fine wires hold the bone fragments in place, often for simpler or less displaced fractures.
- External fixation: occasionally used for very comminuted (multi-fragmentary) or high-energy / open fractures.
Surgery is usually performed under regional or general anaesthesia as a day-case or short-stay procedure. Internal fixation allows early wrist movement, reducing stiffness and improving long-term function.
Recovery & Follow-up
Healing time varies depending on the fracture type, bone quality, and treatment method.
- Conservative treatment: typically 6–8 weeks for bone healing, with gradual return to light activity thereafter.
- Surgical fixation: allows earlier movement, with most patients regaining useful function by 6 weeks and continuing to improve for several months.
Physiotherapy plays an essential role in regaining wrist strength and motion. Temporary stiffness is common but usually resolves with exercise. Some patients may experience residual discomfort or reduced movement, particularly after complex intra-articular fractures.
Follow-up appointments include repeat X-rays to confirm healing, assessment of range of motion, and guidance on returning to work or sport. Most patients regain good function, though mild aching or weakness may persist for several months.
When to seek urgent help
You should seek urgent medical attention if you develop increasing pain, swelling, or numbness in the fingers while in plaster, as this could indicate excessive tightness or nerve compression. After surgery, new redness, warmth, or discharge from the wound, or increasing pain, may signal infection or complications that require prompt review.
Call 999 immediately or attend A&E if you have a new injury with loss of movement or sensation in the hand, rapidly spreading redness or swelling with fever, or sudden severe weakness.
Use NHS 111 for urgent same-day advice if your symptoms are getting quickly worse.
If you have a wrist fracture or related symptoms, we can confirm the cause and tailor a plan – often starting with splints/hand therapy and exercises, with medicines, injections or surgery only where appropriate.
This page provides general information and is not a substitute for individual medical advice.
For emergencies (severe/new weakness, spreading infection, uncontrolled pain, significant injury) call 999, or use NHS 111 for urgent guidance.
Appointments:
- Self-pay patients can book without a GP referral
- Insured patients (Bupa, AXA, Aviva, Vitality, WPA, etc…) can book once authorised.
Clinics are available at:
- The Harborne Hospital – HCA, Birmingham
- Nuffield Health Wolverhampton Hospital
- The Priory Hospital, Birmingham
To book or ask a question, contact Vikki (Private Secretary):
☎ 07510 417479
✉ [email protected]