Wrist Fractures (Broken Wrist)

X-ray of an arm from the elbow down to the hand.

This page has been designed to provide you with the right information about wrist fractures and how to manage them from a physiotherapy point of view.

What is a wrist fracture?

Firstly, a fracture is the same as a break. The word fracture is a medical term and a break is more of a common term to describe an injury to a bone that has caused it to break. For the remainder of this information page, we will use the term fracture.

There are many different types of fractures regardless of this; they all essentially mean the same thing i.e. that one or more of the bones in your wrist joint have been broken.

I’ve heard it called a Colles fracture, is that the same thing?

As mentioned above, there are a number of different types of fracture and they each have their own name. A Colles fracture relates to a break in a bone called the radius as it meets your wrist joint. A Colles fracture is the most common type of wrist fracture.

Is it easy to fracture your wrist?

It really isn’t easy to break a bone in your body. Your bones are incredibly strong and can take an awful lot of knocks, bumps and injuries and will generally not complain. You are more likely to find that you may upset the soft tissues (ligaments, muscles and tendons) following an injury than your bones.

How would you fracture a wrist?

The most common way to fracture a wrist is by falling onto an outstretched hand. In general, if you fall you will instinctively put your hands out to protect your face. As your hand hits the floor, the force and energy created by the fall goes through your hand/ wrist, and if it's more than the wrist can cope with it may cause one or more of the bones to break.

Remember, it is very difficult to break a bone, therefore most of the time, an injury to your wrist would result in a sprained wrist (ligament injury) rather than a fracture.

What if I think I’ve actually broken my wrist?

If you have suffered an injury and your wrist is significantly swollen, perhaps has changed shape, is very painful and you simply cannot move it properly, you should seek help via A&E.

If I go to hospital, what will they do?

Often, a diagnosis can be made by asking some special questions and carrying out a physical examination (if available). However, if the hospital suspects you may have fractured your wrist, then they will arrange an X-ray to check your bones.

What if they find that I’ve broken my wrist, what will happen?

If you have been to the hospital and an X-ray has revealed that you have fractured your wrist, then normally you will be asked to see a specialist orthopaedic (bone and joint specialist) doctor to discuss your options.

Normally, the two options are non-surgical or surgical management.

This means that your wrist is likely to be placed in a plaster cast for support for several weeks to allow your bone/s to heal.

This means that an operation is needed to help your wrist heal. It will normally involve inserting metal screws and/or plates into the bone to hold the fractured pieces together whilst your body heals. It is likely that you will be placed in a plaster cast or splint for several weeks to help with the healing.

Can wrist fractures be managed without surgery?

Yes, indeed. However, the orthopaedic doctor and their team will decide with you what the best option for you might be. Certain types of fractures can be managed more easily without surgery and some types of fractures do better with the help that surgery offers.

What can I expect when the plaster comes off?

For most people, the plaster cast is likely to be kept on for between 4-6 weeks.

You will normally be seen or spoken to by the hospital before removing the cast. Sometimes, you will have another X-ray to check the progress of your wrist but this is not always the case.

If you have had your cast off, it is really important for you to know what is normal as we understand it can sometimes be a worrying time.

First and foremost, wrist fractures can potentially be really quite sore. As you might expect, the discomfort you get from a wrist fracture can be different from person to person. Sometimes they can be very sore and sometimes they may only hurt a little. It is very normal for your wrist to be sore after a fracture and it is just as normal for that soreness to still be there for some time afterwards (weeks possibly into months).

After a wrist fracture, it is very likely your wrist and hand will swell. This is your body’s way of starting the healing process. The swelling helps to ‘stiffen’ your wrist temporarily and helps keep all of the ‘healing cells’ where they need to be to help your wrist recover. Interestingly, you might find the swelling lasts for a long time (possibly into months) and may even still be there when the pain has settled and you are feeling better. This doesn’t necessarily mean anything is wrong, it is just what seems to happen.

Whilst your wrist is sore and swollen, you can expect to find that moving your wrist will be difficult. Again, this is normal and actually will help the early stages of your healing. Once you are ready, it is important to get your wrist moving as soon as you feel that you can, as this will make sure your recovery is started nice and early.

Most people find that their skin is very dry after having a plaster cast on for some time. This is very normal and will improve with time, washing and using a moisturiser.

Sometimes, people may find that their skin, or their scar if they had an operation, can be a little sensitive once the plaster cast has been removed. This is not uncommon and is normally nothing to worry about.

Your muscles are designed to work. If they have not been able to work normally because of the cast, it is very common to find that your muscles (especially your forearm) will be smaller than before the injury.

So, is my wrist healed now?

Fractures typically heal within about 6-8 weeks. There are things that might influence this, such as any pre-existing health conditions like diabetes or if you smoke, but typically once you pass the 6-8 week timescale you can consider your wrist healed.

Unfortunately, just because the fracture itself might be healed (a higher level of healing goes on for several months but you won’t be aware of this), does not mean that any pain will stop or the movement will come back by itself. This is where rehabilitation and physiotherapy can help.

Can I break it again by using it?

Your bones were strong before the fracture and they will still be strong now after the fracture. Your wrist may be sore and you may find that your confidence to use it normally might have been affected since the break, but it is not fragile and it is not vulnerable.

By exercising your wrist and doing normal daily things, you can help the healing process even more which will help you get a better result overall.

Can I expect my wrist to go back to exactly how it was before I broke it?

This is a really good question. Once you have broken a bone, especially if it is close to a joint, you have effectively changed its anatomy. With this in mind, you may find that after a fracture, your wrist may not be able to go back to everything you did before or do things in the way you did before 100%. The good news is that if you work hard, are patient and kind to yourself and give it the right amount of time, you will make the best recovery that you can.

Ok, what can I start doing to help my wrist get better?

Any type of pain, no matter where it is, is unpleasant and can sometimes become a bit concerning. We have designed this page specifically to give you the right information about wrist fractures and hopefully some reassurance that even if it’s really rather sore, your wrist is an amazingly strong and robust piece of kit, and even if it's sore and hard work, you are doing the right things to help yourself get better.

Interestingly, after any type of injury, including wrist fractures, it is important to recognise that sometimes there can be an emotional part to the injury and your recovery. After a wrist fracture, you might not feel confident to use your hand or may feel that it will let you down or that you might injure it again. Accepting that these feelings or concerns might be something important enough to need working on as part of your rehabilitation, might mean that you get a better overall outcome. It is hoped that the information on this page will help you with your confidence, but you can always discuss any worries you may have with your physiotherapist.

Your hand and wrist are designed to be used. Therefore, it is important to try and get it going as soon as you can. It is likely to be sore but you will not make it worse by using it, in fact it will help your wrist start to get better more effectively. You may need to adjust how you use your wrist or how long you do things for in the first stages, but it is something that improves over time for most people.

One of the best things for most aches and pain is normal, confident movement. Your wrist will be sore, stiff and swollen after a break and it might feel like the last thing you might want to do is to move it, but movement is the best medicine for your wrist. Us physios like to say ‘motion is lotion!’ When you are ready, try moving your wrist as far as you are comfortable with as regularly as you can. You will not injure your wrist or upset the healing process by moving it.

We have a selection of exercises to help you get moving at the bottom of this page.

Once you have started working on your wrist movement and are starting to feel the movement coming back, you might want to add some other exercise into your rehabilitation to help you make the best recovery.

Working on the strength of your wrist and hand are normally really useful in helping you get a good outcome after a wrist fracture. We have a selection of exercises at the bottom of this page to help provide you with some ideas.

Is there anything else I can do?

As mentioned previously, wrist fractures can be sore. Some people will choose to manage this pain with pain relief, whilst some may choose to avoid medication. If you need pain relief and either don’t have any or what you have isn’t working, please speak with your GP or pharmacist. Applying something cold to your wrist may also be useful in helping with some of the pain (do remember to wrap your frozen peas in a towel before applying them to your skin to avoid cold burns).

Getting your wrist moving is key to getting a good result after a wrist fracture and helping to reduce any swelling. Some people may find resting with their hand up (above the elbow or shoulder) can help. It is worth remembering that swelling will often ‘hang around’ for some time (possibly into weeks or months), but this doesn’t necessarily mean anything is wrong. If your wrist is hot, red and swollen you should seek help from your GP or hospital consultant.

Fracturing your wrist can be traumatic and for some people, really quite upsetting. You may feel that your confidence has been reduced and you might even find yourself worried about using your wrist. These are entirely normal reactions to an injury.

Any progress you will make will likely take time and the ‘road to recovery’ is often bumpy (meaning it will take effort, energy and perseverance). Adjusting things that you find sore, asking for help if you can, being realistic about the difficulties you are having and what you expect from yourself can all be helpful in making your rehabilitation easier.

Is there anything I should look out for?

After a fracture or a period of time where your wrist hasn’t been able to move (in a plaster cast), it is important to look out for the following symptoms:

Redness, swelling and heat around the wrist, especially if accompanied by a fever or generally feeling unwell
Poor healing of your wound (only applicable if you have had an operation) – wet or oozing, especially if accompanied by a fever or feeling generally unwell
Gross levels of pain that is not easily controlled with pain relief.
Significant swelling of your arm (especially if pressing it leaves a finger mark)
Any of the above, especially if you have had a past history of Deep Vein Thrombosis (DVT)

If you have any concerns about any of the symptoms listed above, you should speak with your GP, 111 or seek help from A&E.

What exercises should I be doing to start with?

In the earliest stages of your recovery i.e. within the first few weeks, it is recommended that you simply try to gently move the wrist and fingers as well as you can and as far as is comfortable. We have provided a selection of suitable exercises below.

Frequently asked questions

Q: My wrist feels tight and a bit strange. Is that normal?

A: It is not unusual to find that your wrist feels strange after an injury. It is normal to feel tight or stiff after a fracture of any kind, but these things often ease with time and some gentle exercises.

Q: My wrist is still swollen after all this time. Is this normal?

A: Swelling can sometimes be the last thing to settle after injuries. It can sometimes hang around for weeks into months after the injury however, if you are feeling better, moving better and doing more, it is not something you should be worried about.

Q: Why does my shoulder hurt since I broke my wrist?

A: Again, this is something that can be fairly common after a wrist fracture. If you managed to injure your wrist after a fall or an accident, it can sometimes be that your shoulder may have been upset at the same time. Sometimes, as the pain settles with the wrist you can find that the issues with the shoulder start to come to the surface.

You can find some excellent guidance and exercises for common shoulder problems here: Shoulder Pain

Q: When can I drive again?

A: It is likely that you will not be able to return to driving for at least 6 weeks after your injury. It is each individual’s responsibility to ensure they are fit to drive. As well as making sure you are in full control of the vehicle at all times, you should ensure you can confidently and without any hesitation, perform an emergency stop before even considering driving on public roads.

It is always recommended to contact your insurance company one month before you return to driving to ensure your insurance is valid. This advice is the same if you drive an automatic car.

Q: When can I get back to sport?

A: This will be dictated by your wrist and your sport. Most people will find their wrist feels better after a few weeks/ months. By working on the movement, strength and balance exercises, as well as being patient, you may find that going back to most sports by about 3 months will be successful (this can be very variable).

Exercise tip:

Movement exercises: You should try to complete these little and often throughout the day. Try to move your wrist as far as is comfortable.

Strength exercises: You should aim to complete the exercises (as many or as few as you want to) about 3 to 4 times a week.

Each exercise should be completed between 8-12 times (or repetitions) for 3 to 4 sets. Make sure you have about 1 minute's rest in between each set.

For the strengthening exercises, remember, in order to change your muscles you need to challenge them. In other words, you should really feel the effort with each set of exercises and should really not be able to do more than 12 each time around.