When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Wrist fractures

Last reviewed: 11 Oct 2024
Last updated: 04 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • history of trauma or osteoporosis
  • wrist pain
  • tenderness over the distal radius
  • swelling
Full details

Other diagnostic factors

  • deformity
  • tenderness in the anatomic snuff-box
  • numbness in the fingers
  • hypoesthesia
  • open wound
  • absent pulse
Full details

Risk factors

  • trauma
  • osteoporosis
Full details

Diagnostic tests

1st tests to order

  • plain radiographs of the wrist
Full details

Tests to consider

  • CT wrist
  • MRI (without contrast) wrist
  • dual-energy x-ray absorptiometry (DXA)
Full details

Treatment algorithm

INITIAL

closed

open

ACUTE

isolated fracture of distal radius

isolated scaphoid fracture

concomitant distal radius and scaphoid fractures

ONGOING

confirmed wrist fracture

Contributors

Authors

Niels W.L. Schep, MD

Trauma, Hand and Wrist Surgeon

Department of Trauma and Hand Surgery

Maasstad Hospital

Rotterdam

Netherlands

Disclosures

NS declares that he has no competing interests.

Acknowledgements

Dr Niels W.L. Schep would like to gratefully acknowledge Dr Jeffrey N. Lawton, Dr John R. Lien, Dr Gregory D. Byrda, Dr Tamara D. Rozental, and Dr Chaitanya S. Mudgal, previous contributors to this topic.

Disclosures

JNL is a consultant for Innomed Inc, has received honoraria from The AO Foundation for teaching courses, and has been sponsored for research by DePuy Synthes. JRL and GDB declare that they have no competing interests. TDR is an author of several references cited in this topic. CSM has been reimbursed by AO North America and Asia Pacific for being a faculty member during educational conferences.

Peer reviewers

Asif Ilyas, MD

Program Director of Hand and Upper Extremity Surgery

Rothman Institute

Associate Professor of Orthopaedic Surgery

Thomas Jefferson University

Philadelphia

PA

Disclosures

AI declares that he has no competing interests.

Isam Atroshi, MD, PhD

Associate Professor of Orthopaedics

Lund University

Chief

Hand Surgery Section

Department of Orthopaedics

Hässleholm and Kristianstad Hospitals

Sweden

Disclosures

Not disclosed.

  • Wrist fractures images
  • Differentials

    • Wrist strain
    • Ligamentous carpal injury
    • Triangular fibrocartilage complex (TFCC) tear
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: chronic hand and wrist pain
    • Prevention of surgical site infections after major extremity trauma
    More Guidelines
  • Patient information

    Carpal tunnel syndrome

    Menopause: what is it?

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer