Wrist fractures

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Last reviewed: 6 Aug 2025
Last updated: 22 Jun 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • wrist pain
  • tenderness over the distal radius
  • swelling
Full details

Other diagnostic factors

  • deformity
  • tenderness in the anatomic snuff-box
  • numbness in the fingers
  • hypo-aesthesia
  • open wound
Full details

Risk factors

  • trauma
  • osteopenia
  • osteoporosis
Full details

Diagnostic investigations

1st investigations to order

  • plain x-rays of the wrist
Full details

Investigations to consider

  • CT wrist
  • MRI (without contrast) wrist
Full details

Treatment algorithm

ACUTE

isolated fracture of distal radius

isolated scaphoid fracture

concomitant distal radius and scaphoid fractures

ONGOING

confirmed wrist fracture

Contributors

Expert advisers

Michael Barrett, MBChB, FRCS (Tr & Orth), PG Cert Med Ed

Consultant Trauma and Orthopaedic Surgeon

Cambridge University Hospitals NHS Foundation Trust

Cambridge

UK

Disclosures

MB is a director of Orthohub.xyz, an online education platform for orthopaedic surgeons. Orthohub.xyz receives sponsorship from the healthcare industry.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Niels W.L. Schep, MD

Trauma, Hand, and Wrist Surgeon

Department of Trauma and Hand Surgery

Maasstad Hospital

Rotterdam

Netherlands

Disclosures

NWLS is an author of several references cited in this topic. He is a consultant for Synthes, Medartis, and Arthrex, and has received honoraria from The AO Foundation for teaching courses.

Peer reviewers

Ramon Tahmassebi, MBBS, BSc (Hons), FRCS (Tr & Orth)

Consultant Trauma & Orthopaedic Surgeon

Clinical Director Trauma & Orthopaedic Surgery

King's College Hospital NHS Foundation Trust

London

UK

Disclosures

RT declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

British Society for Surgery of the Hand; British Orthopaedic Association. Best practice for management of distal radial fractures. 2018 [internet publication].Full text

National Institute for Health and Care Excellence. Fractures (non-complex): assessment and management. February 2016 [internet publication].Full text

British Orthopaedic Association. British Orthopaedic Association Standard for Trauma (BOAST): the management of distal radial fractures. December 2017 [internet publication].Full text

British Orthopaedic Association. British Orthopaedic Association Standard for Trauma (BOAST): early management of the paediatric forearm fracture. May 2021 [internet publication].Full text

National Institute for Health and Care Excellence. Fractures (complex): assessment and management. November 2022 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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