Most important wrist fracture types and their respective clinical presentations are:

• Distal radius fractures - Being the most common type of wrist fracture, distal radius fracture encompasses 17% of all fractures seen in the emergency department, and falling onto an outstretched hand (often encountered in ice hockey players and both ice and inline skaters) is the main mechanism of injury [1] [2]. Swelling of the wrist, a limited range of motion, tenderness along the distal radius and injury of the median nerve leading to numbness of the tip of the index finger can be observed during physical examination [2] [3].
• Scaphoid fracture - Seen in previously healthy and young individuals who either fall on the outstretched arm or provoke a forced dorsiflexion of the wrist, this type of fracture presents with tenderness over the anatomic snuff box or the distal scaphoid tubercle, accompanied by a limited range of motion [4]. Pain and reduced grip strength are infrequently reported [4].
• Lunate fracture - Similarly to scaphoid and distal radius fractures, injury to the lunate bone occurs after falling onto an outstretched hand [1], but compression injury or a direct blow to the wrist may be responsible as well [1] [5]. It is very rarely encountered in practice, and wrist pain may be the only clinical sign [5].
• The hook of hamate fracture - Baseball, golf, and tennis players are shown to be at the highest risk for this type of fracture since transmission of the force from the bat, club or racquet to the palm is the mechanism of fracture [2]. Ulnar or median nerve injury manifesting as numbness, as well as wrist pain, are main complaints.
• Triquetrum fracture - Dorsal cortical fracture of the triquetrum is regarded as the second most common carpal fracture (after scaphoid) [2], and symptoms include nonspecific tenderness and swelling. The diagnosis is frequently misinterpreted as wrist sprain, however, which is why detailed radiographic workups are imperative in distinguishing between different types of injury [1] [2].
• Trapezium - Direct high-level impact to the bone is the main mode of fracture, and is frequently associated with distal radial injury [2].

• Pain

  Isolated scaphoid fractures can also occur and should be considered in the differential of a patient with radial-sided wrist pain after a fall on their hand. [bestpractice.bmj.com]

  As fracture-related surgery implies a risk of developing neuropathic pain and complex regional pain syndrome (CRPS), further studies investigating the prevalence and pain characteristics are required. [ncbi.nlm.nih.gov]

  Pain and reduced grip strength are infrequently reported. [symptoma.com]

  Fracture is condition that involves the breaking of bones, which results in pain. Boxer's Fracture A Boxer’s fracture refers to a break at the end of the bone nearest the knuckle of the little finger. [emoryhealthcare.org]

• Falling

  Isolated scaphoid fractures can also occur and should be considered in the differential of a patient with radial-sided wrist pain after a fall on their hand. [bestpractice.bmj.com]

  The majority of falls causing wrist fracture occurred outdoors, during winter months, as a result of a slip or trip while walking. Half of these falls resulted in other injuries including head, neck, and spine injuries. [ncbi.nlm.nih.gov]

  Lunate fracture - Similarly to scaphoid and distal radius fractures, injury to the lunate bone occurs after falling onto an outstretched hand, but compression injury or a direct blow to the wrist may be responsible as well. [symptoma.com]

  The natural response to a fall is to stretch out a hand to break the fall, and falls tend to occur more often in beginners. [physioroom.com]

• Swelling

  For the first 72 hours after the injury the wrist should be elevated to reduce swelling. [physioroom.com]

  There is usually no visible deformity and only minimal swelling. Since there is no deformity, many people with this injury mistakenly assume that they have just sprained their wrist. [emoryhealthcare.org]

  Triquetrum fracture - Dorsal cortical fracture of the triquetrum is regarded as the second most common carpal fracture (after scaphoid), and symptoms include nonspecific tenderness and swelling. [symptoma.com]

  This can help reduce swelling and pain. Apply an ice pack to the injured area. Use the ice for 15 to 20 minutes every few hours for the first few days while the swelling goes down. [mountsinai.org]

• Weakness

  The age-dependence in normal subjects was weak. When all the study subjects were pooled, modest correlations between BUA of the calcaneus and BMD at all measured skeletal sites were found (rs values 0.3-0.4). [ncbi.nlm.nih.gov]

• Severe Pain

  Other main outcomes included the incidence of seeking any form of medical attention for pain and self-reporting of severe pain in the first 48 hours. RESULTS: Of 1008 identified patients, 419 could be contacted; 195 qualified for analysis. [ncbi.nlm.nih.gov]

  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. [emedicinehealth.com]

  Patients with fractures typically experience wrist fracture signals including severe pain, swelling, and deformity of the injured wrist. [ksfortho.com]

  If you fall on your hand/wrist and have ANY of the following you should seek EMERGENCY treatment –Severe pain –Obvious swelling –Obvious deformity –Numbness/tingling –An open wound Do I have to go to the ER? No. [denverortho.com]

• Nausea

  Opioids side effects like nausea, vomiting and constipation. Infection from pump and catheter pocket may spread in CSF and cause serious infection like Meningitis and Encephalitis. 5. [epainassist.com]

• Vomiting

  Opioids side effects like nausea, vomiting and constipation. Infection from pump and catheter pocket may spread in CSF and cause serious infection like Meningitis and Encephalitis. 5. [epainassist.com]

• Fracture

  Most important wrist fracture types and their respective clinical presentations are: Distal radius fractures - Being the most common type of wrist fracture, distal radius fracture encompasses 17% of all fractures seen in the emergency department, and [symptoma.com]

  Fractures of the distal radius are the most common fracture in adults and are typically caused by a fall on the outstretched hand. This injury may be accompanied by fractures of the ulnar styloid, the distal ulna, and the scaphoid. [bestpractice.bmj.com]

  Pediatric Upper Extremity Fractures Childhood fractures occur frequently. [emoryhealthcare.org]

  CONCLUSION: Although elbow fractures occasionally complicate distal forearm fractures in children, our findings indicate that a careful physical evaluation of the elbow is sufficient to guide further radiographic investigation. [ncbi.nlm.nih.gov]

  Smith's fracture (distal radius with volar displacement of fragments). Scaphoid fracture. Barton's fracture (fracture dislocation of the radiocarpal joint). Chauffeur's fracture (fracture of the radial styloid). [patient.info]

• Osteoporosis

  Those identified were subjected to further review to establish rates of osteoporosis and/or hip fracture. Osteoporosis and/or hip fracture rates were also determined for a control population. [ncbi.nlm.nih.gov]

• Wrist Pain

  Purely ligamentous injuries can be a cause of wrist pain after a fall on an outstretched hand in the setting of normal radiographs. Wrist fractures include fractures that affect the distal ends of the radius, ulna, and carpus. [bestpractice.bmj.com]

  It is very rarely encountered in practice, and wrist pain may be the only clinical sign. [symptoma.com]

  Symptoms include a great deal of wrist pain, a "dinner fork" deformity, wrist swelling and an inability to use the wrist and hand. [physioroom.com]

  Failure to recognize a scaphoid fracture can result in non-union and chronic thumb and wrist pain. [mikereinold.com]

  Signs of a Broken Wrist Wrist pain Swelling Deformity of the wrist When a patient comes to the emergency room with wrist pain, and evidence of a possibly broken wrist, an x-ray will be obtained of the injured area. [orthopedics.about.com]

• Wrist Arthritis

  Second, inflammatory diseases such as rheumatoid arthritis or lupus can cause wrist arthritis. The third common form of wrist arthritis is called Post Traumatic Arthritis. [medicine.umich.edu]

  Thumb & Wrist Injuries Bennett's Fracture (Scaphoid) Broken Wrist (Colles) Broken Wrist (Capitate) Broken Wrist Broken Wrist Carpal Tunnel Syndrome Mallet Finger Sprained Thumb Wrist Arthritis [physioroom.com]

  Symptoms of arthritis in the wrist may include: Aching Stiffness Decreased range of motion in the wrist Pain with activities such as lifting, gripping, or weight bearing Treatment for arthritis focuses on improving symptoms. [orthoinfo.aaos.org]

  A Colles fracture is a wrist fracture involving a break of the end of the radius bone of the forearm ("distal radius fracture"). What caused it? Wrist arthritis may occur following a distal radius fracture. [eatonhand.com]

• Joint Dislocation

  Hematoma (blood clot) in subcutaneous tissue and wrist joint. Wrist joint dislocation associated with fracture of wrist joint. Osteoporosis of wrist joint bone. Necrotic fractured bone. [epainassist.com]

  Specifically, these include articular disk injuries of the wrist, dislocations of the inferior radioulnar joint, and traumatic dislocation of the distal end of the ulna. [emedicine.medscape.com]

• Tingling

  When the pressure becomes severe enough to disturb the way the nerve works, you can experience numbness, tingling and pain in your elbow, forearm, hand and fingers. [northwell.edu]

  Signs of injury include pain, swelling, bruising, and tingling in the hand and fingers. The diagnosis must be made by a medical professional, and x-rays will be ordered to evaluate the extent of injury. [essexortho.net]

  Carpal tunnel syndrome, causing numbness and tingling in the fingertips may also develop when a wrist fracture narrows the path for the nerve and tendons in front of the bone. [eatonhand.com]

  You may also experience nerve damage to the fingers as the nerves can become tangled up with the bone and thus cause a tingling sensation in the fingers or perhaps loss of normal movement. Note that it is not possible to dislocate your wrist. [healthguidance.org]

Patient history and findings observed during the physical examination are sufficient in turning the physician's attention to a wrist-related pathology, but imaging studies are necessary to confirm the presence of a fracture. Plain radiography of the injured wrist is an excellent initial method, but only if images are obtained in the adequate plane, depending on the site of injury [1]. For example, scaphoid fractures require a lateral radiographic view, while distal radius fractures require both posteroanterior (PA) and lateral views, an external oblique projection and a PA image with ulnar deviation of the wrist [1]. If the cause of symptoms is undisclosed with plain radiography, more sensitive imaging methods should be employed. Ultrasonography is recommended in the setting of suspected scaphoid fractures [6], but it is regarded as an inferior procedure compared to computed tomography (CT) and magnetic resonance imaging (MRI), described as the gold standard in imaging workup of the wrist [2] [7]. These procedures can determine the exact site of fracture with great efficacy, and more importantly, determine the presence of other potential injuries (e.g., soft tissue injuries such as ligament tears or additional fractures) [2], which is why they are often recommended in early workup [2] [7]. In some patients, technetium 99 (99 Te) bone scintigraphy may be used as a diagnostic tool [1].

Our hand surgeons at Emory Orthopaedics & Spine Center will discuss the best treatment option for you. Learn more about our Hand & Upper Extremity Fracture Treatment Options [emoryhealthcare.org]

Participants were divided into two treatment groups: computer-aided treatment (high technology) and traditional brush machine treatment (low technology). [ncbi.nlm.nih.gov]

Prognosis Rate of recovery and the prognosis from a wrist fracture will depend on a number of factors: Severity – Minor fractures do well with immobilization and hand therapy, while fractures that are more severe and require surgery or effect joint integrity [twinboro.com]

At one extreme a stable, undisplaced extra-articular fracture has an excellent prognosis. At the other an unstable, displaced intra-articular fracture is difficult to treat and has a poor prognosis. [radiologyassistant.nl]

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. [emedicinehealth.com]

Existing evidence suggests an association between fracture type and received treatment with further functional prognosis [ 4 – 8 ]. [bmcgeriatr.biomedcentral.com]

Although a shared genetic etiology is often assumed between fracture and low BMD, this has not been shown to be the case. [ncbi.nlm.nih.gov]

Background & Etiology The wrist joint is comprised of the distal ends of the radius and ulna (forearm bones) and eight carpal bones (which form the “floor” of the carpal tunnel.) A fracture is defined as a partial or complete crack in a bone. [twinboro.com]

Epidemiology of Wrist Joint Fractures- Several epidemiological studies performed in USA suggest that- Upper extremity injuries are the most common injuries seen in emergency room. [epainassist.com]

"Epidemiology of distal radius fracture in Stockholm 1981-82". Acta Orthopaedica Scandinavica. 59 (6): 701–703. doi : 10.3109/17453678809149429. ISSN 0001-6470. [en.wikipedia.org]

Epidemiology Fractures of the wrist are common, representing about a quarter of all fractures of limbs. They are more common in children and in young adults, especially those involved in risk-taking activities. [patient.info]

Several studies support the efficacy of vitamin C in preventing CRPS-I, although the data are somewhat conflicting. [ncbi.nlm.nih.gov]

Early recognition and treatment of any of these factors can prevent long-term problems. But is it possible to tell ahead of time who might develop acute CTS after distal radial fracture? The goal would be to prevent carpal tunnel syndrome. [eorthopod.com]

1. Goldfarb CA, Yin Y, Gilula LA, Fisher AJ, Boyer MI. Wrist fractures: what the clinician wants to know. Radiology. 2001;219(1):11-28.
2. Chen NC, Jupiter JB, Jebson PJL. Sports-Related Wrist Injuries in Adults. Sports Health. 2009;1(6):469-477.
3. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
4. Steinmann SP, Adams JE. Scaphoid fractures and nonunions: diagnosis and treatment. J Orthop Sci. 2006;11(4):424-431.
5. Galbraith PJ, Richardson ML. Fracture of the Lunate: Radiographic Findings and Case Report. Radiol Case Rep. 2007;2(1):13-16.
6. Senall JA, Failla JM, Bouffard JA, van Holsbeeck M. Ultrasound for the early diagnosis of clinically suspected scaphoid fracture. J Hand Surg Am. 2004;29(3):400-405.
7. Murthy NS, Ringler MD. MR Imaging of Carpal Fractures. Magn Reson Imaging Clin N Am. 2015;23(3):405-416.