At a glance

  • Many wrist injuries happen during a fall or sports activities.

  • Sprains get better within a few weeks.

  • Fractures and torn ligaments take longer to heal.

  • The hand can be kept still with the help of a bandage, splint or plaster cast.

  • Surgery is only rarely needed.

Introduction

photo of a child falling (PantherMedia / anatols)

If you trip and fall, it’s natural to automatically put out your hands to break the fall. This can sometimes lead to a wrist injury. Although wrist injuries are painful, they often get better within a few weeks. Sometimes the wrist has to be kept still for a longer time. Wrist injuries are rarely so bad that surgery is needed.

Wrist injuries are generally divided up into the following types:

  • Sprains: This is where the wrist is stretched or bent so much that the ligaments are overstrained.
  • Torn ligament: A ligament in the wrist tears partially or completely.
  • Dislocation: This is where a bone slips out of a joint. Muscles, ligaments and the joint capsule may become damaged as a result.
  • Bone fracture: Several bones in the wrist can break, including the radius, ulna, the carpal bones (e.g. the scaphoid and lunate bones) or the metacarpal bones. Depending on the type of fracture, it can also damage ligaments, nerves and certain parts of the joint.

The more the hand is overstretched or bent, the more likely it is to result in ligament injuries or a fracture.

 

Illustration: Sprained wristSprained wrist

Symptoms

Wrist injuries can be very painful. Fractures and dislocations can often clearly be seen from the outside and hurt more than sprains do. Swelling and bruising are common too. If nerves are injured, the feeling in your hand might be affected – for instance, your fingers might feel numb or tingle. It’s important to see a doctor soon if you have abnormal sensations, severe pain and a visible deformity. If you can no longer move the hand at all, it’s an emergency and you should go straight to a hospital.

Illustration: Healthy wrist and dislocated wrist

Ligament injuries might not hurt that much at first, but longer-lasting symptoms may develop. Wrist joint instability caused by torn ligaments often only becomes noticeable after a few weeks. Your hand may then suddenly give way and fall to one side when you put pressure on it.

 

Illustration: Torn ligament in the wristTorn ligament in the wrist

Causes

Wrist injuries often occur when people put out their hand to break a fall. If the wrist joint is overstretched or bent too far as a result, the joint capsule, ligaments and bones may become damaged. These injuries often happen during sports activities. Many older people are prone to falls in everyday life too.

Sprains can occur as a result of sudden movements as well, for instance when throwing a ball or  swinging a tennis racket.

People who have osteoporosis are generally more likely to break bones, so they’re also more likely to injure their wrist if they fall.

These injuries are common in children too because their bones, ligaments and joints haven't stopped developing yet. But injuries usually heal well in children.

 

Illustration: Wrist fractureWrist fracture

Outlook

Mild sprains get better within 2 to 3 weeks and don't have any long-term consequences. It can take up to six months for a torn ligament or fracture to heal completely, though. These more severe injuries can also result in chronic joint instability or osteoarthritis, or permanently affect your ability to move your wrist and hand.

Diagnosis

The doctor examines the hand to find out how well you can move it, whether there is any swelling, and where exactly it hurts. This hand examination is often enough to diagnose mild sprains. But an x-ray may be needed as well. If it is thought that the wrist might be dislocated or fractured, or that a ligament is torn, further imaging techniques (e.g. CT or MRI scans) may be considered.

Treatment

Right after injuring the wrist, it's important to stop moving the joint as soon as possible and then rest it. Keeping it raised (elevated) can help to limit the swelling. Depending on the type of injury, a firm elasticated bandage (tape), splint or plaster cast can be used. Pain can be treated with creams or tablets (such as acetaminophen, also known as paracetamol). If you take a non-steroidal anti-inflammatory (NSAID) painkiller over a long period of time, it can be a good idea to take medication to protect your stomach too.

Whether you need to keep your hand still (immobilize it) – and for how long – will depend on the type of injury and the healing process. This can be determined by a doctor. Sometimes there's no need to keep it still at all. If the wrist is sprained, a few days is often enough. People who have torn a ligament or fractured a bone need to keep their hand still for several weeks, though, to allow the injury to heal.

Surgery is considered if, for instance, bones need to be put back into the correct position after a fracture, if a ligament is completely torn, or if there is nerve damage. Depending on the type of surgery, the wrist joint is immobilized for a few weeks after the operation. But you don't always need to keep the wrist still afterwards, and it's generally best to start moving it again as soon as possible. Sometimes people are allowed to move their hand again immediately after wrist surgery. If the wrist is dislocated, the bones are moved back into the correct position under local or general anesthesia, depending on how severe the injury is.

Physical therapy and occupational therapy can help the healing process along after a wrist injury. Certain exercises can improve your ability to move the hand and strengthen the muscles.

Sometimes the treatment for wrist injuries is different in children than in adults. So – depending on the type of injury – it can be a good idea for children to see a doctor who has specialized in pediatric surgery.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.