Hand and Upper Limb Orthopedic Surgeon Dr. Alejandro Badia offers tips on diagnosing and treating wrist injury

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Wrist Injury: Is Your Wrist Sprained or Broken?

Dr. Alejandro Badia

Specific tests can tell the difference between these types of wrist injuries and point to the right treatment.

You’ve had a fall or mishap and now your wrist really hurts, but is it sprained – or broken? Sometimes it’s difficult to tell, but specific tests can tell the difference between these types of wrist injuries and point to the right treatment, according to orthopedic surgeon Alejandro Badia, MD, founder of Badia Hand to Shoulder Center and OrthoNOW and author of Healthcare from the Trenches.

A complex joint that allows for both front-to-back and side-to-side movement, the wrist is composed of the ends of 2 long arm bones along with 8 small, oval-shaped wrist bones and the bases of each of the 5 fingers. With all of these bones converging in one place, it’s no wonder that the wrist is vulnerable to injury, says Dr. Badia, who specializes in treating injuries of the upper limbs, which include the wrist, hand, fingers, elbow and shoulder.

“Some wrist injuries – say, from a car or sports accident – are obviously more severe than others,” he explains. "But most of us injure our wrists from time to time by tripping and falling. Our wrists aren’t designed to absorb the impact they receive when we try to ‘catch’ ourselves by putting our hands out and landing on them during a fall.”

Telling the difference
If you’ve hurt your wrist but aren’t sure if it’s sprained or broken (also called fractured), you may be wondering what the difference is. Simply put, Dr. Badia says, a sprain means the ligaments supporting the wrist stretch beyond their limits and tear. Meanwhile, a fracture means one or more bones in the wrist have broken.

“Both injuries can produce severe pain, but – contrary to widespread belief – sprains don’t always hurt less than fractures,” he explains, adding that symptoms for both can include:

  • Pain, especially when you move your wrist
  • Swelling in the wrist or hand
  • Difficulty picking up things
  • Limited range of motion
  • Bruising

On the other hand, a broken wrist may provide some nasty clues about its status, as your wrist may appear deformed. “The bone may be pushing against the skin or even poke through it,” Dr. Badia says. “Also, with a break you may hear a snap or pop in your wrist, which will then immediately swell and worsen, even if you put ice on it.”

If you think you’ve fractured your wrist, or even if you suspect a sprain but your pain isn’t quickly improving, it’s time to see a doctor with particular training and expertise in treating wrist problems, to be properly diagnosed, Dr. Badia advises. After an exam, your doctor may order imaging tests such as X-rays, or MRI or CT scans, that can help determine whether you’ve sprained or fractured your wrist.

Treatment tips
After a diagnostic process has revealed a sprain or fracture, a variety of treatments may be recommended, depending on the outcome.

For a sprained wrist, home treatment may include resting the joint for at least 48 hours; applying ice several times a day for 20 minutes at a time; compressing the joint with an elastic compression bandage; and elevating your wrist higher than heart level as often as possible. In most cases a mild wrist sprain will only need compression and ice.

“Moderate sprains might require wearing a wrist splint for a week or more, but you may also be advised to do some stretching exercises when your wrist comes out of the splint to help you regain full range of motion,” he says. “In unusual cases, severe sprains might need surgery to reconnect wrist ligaments to bone or a tendon graft to reconstruct the injured ligament.” Dr. Badia adds that the good news is that in experienced hands, almost all wrist surgery is performed like in the knee with arthroscopy. Two little holes in the wrist allow a fiberoptic camera to refine the diagnosis and then direct treatment through tiny instruments inserted in different sections of the complex wrist joint. This is why it’s important to find the right specialist, one with training and expertise in treating wrists, to assess AND treat your wrist pain.

A broken wrist may be placed in a splint or cast for several weeks to align the broken ends of the bone, Dr. Badia says. But some fractures are also severe enough to require surgery to set correctly.

“If you have a complex or open wrist fracture, a surgeon may need to implant hardware such as pins, rods or screws to hold your bones in place while they heal,” he explains.

With either a sprained or fractured wrist, however, most patients recover fully after a period of immobilizing the injured joint and restoring movement through exercise and rehabilitation afterward.

“It’s important for either type of injury to be seen and treated as soon as possible to avoid any lasting pain or other issues,” Dr. Badia says. “Our everyday movements require fully functional wrists, so don’t ignore wrist injuries.”

Bio: Alejandro Badia, MD, FACS, is an internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a network of walk-in orthopedic centers. Dr. Badia is the author of Healthcare from the Trenches. http://www.drbadia.com http://www.orthonowcare.com

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