Wrist sprain and wrist fracture have very similar symptoms making it difficult to determine the type of injury. Both wrist sprain and wrist fracture will result in pain and swelling in the area. The wrist will also be tender and warm to the touch.
Further, one may notice bruising and difficulty moving the joint.
If the individual felt a tearing or popping sensation inside the wrist at the time of injury, and there is some muscle weakness, it is most probably a wrist sprain. Dull aching pain or constant sharp pain is also an indicator of a wrist sprain.
If the individual experiences extreme pain or increased pain during wrist movement or gripping or squeezing with the hand, it indicates a wrist fracture.
A wrist fracture may also be accompanied by an obvious deformity as well as an open wound. In extreme cases, the bone may stick out of the skin.
A wrist sprain occurs when there is an injury to any of the wrist ligaments. Ligaments are responsible for bridging the bones and keeping them stable and in place.
When a joint is moved beyond its normal range of motion, such as excessive bending, it results in a sprain. It is categorized into three types:
- Grade I or Mild: The ligament is stretched.
- Grade II or Moderate: The ligament is partially torn.
- Grade III or Severe: The ligament is completely torn.
A break or a crack in any of the bones of the wrist is called a wrist fracture. Fractures of the wrist are categorized as follows:
- Open fracture: A part of the broken bone punctures the skin.
- Closed fracture: The broken bone remains inside, and the skin is undamaged.
- Comminuted fracture: The bone is separated into three or more pieces.
- Partial fracture: An incomplete fracture.
- Complete fracture: The bones are completely separated and have moved out of place.
- Intra-articular fracture: The fracture extends into the joint.
- Extra-articular fracture: the broken bone does not extend into the joint.
Wrist fractures are fairly common as the hand and arm is often used to break a fall during a trip or slip. Below are the most frequent types of wrist fracture:
- Distal radius fracture: A break at the distal radius [the end of the larger bone of the forearm] It is the most frequently fractured bone of the wrist.
- Scaphoid fracture: The scaphoid is one of the larger carpal bones of the wrist and is located at the base of the thumb. It is the second most common fractured bone of the wrist. Scaphoid fractures are difficult to determine and treat. The farther the fracture line from the thumb, the more difficult it is to treat because of poor blood supply.
- Radial styloid fracture or Chauffer’s fracture: A break at the radial styloid process [the bulge at the end of the radius]
- Ulnar styloid fracture: a break at the ulnar styloid process[the bulge at the end of the ulna]
Causes of Wrist Sprain and Wrist Fracture
The most common cause of wrist sprain or wrist fracture is falling on an outstretched hand (FOOSH) when trying to break a fall after a slip or a trip.
Both may also be caused by accidents while participating in a sports activity. Generally, a fracture is considered a more severe injury than a sprain.
The degree of severity of the injury depends on the position of the wrist (whether it was bent or twisted), if the individual has osteoporosis or is taking medications that make the bones brittle, and the type of activity involved.
The most common sports that cause wrist sprain are basketball, gymnastics, skating, and skateboarding.
Wrist fractures are common in individuals who participate in horseback riding, hockey, football, and skiing.
When to Visit a Doctor
An individual should seek medical attention if the symptoms mentioned above are experienced. If one is unsure if the accident resulted in a wrist sprain or wrist fracture, then a doctor should be sought immediately to provide a diagnosis and give appropriate treatment.
A wrist fracture warrants urgent medical care, especially if it is an open fracture, to prevent further complications, realign the bones, and promote faster healing. Immediate treatment will also lower the chances of joint stiffness and muscle weakness.
If the individual is elderly or has a condition that makes the bone brittle and prone to breakage, a doctor should be sought right after the injury occurred.
This ensures that a proper diagnosis and treatment will be given and prevent further problems that may arise from the injury.
Treatment for Wrist Sprain and Wrist Fracture
Mild to moderate wrist sprain is fairly easy to treat. It can be easily managed at home with rest, ice application to reduce pain & swelling followed by warm compress after 48 hrs, compression bandages, and elevation above the heart.
Non-steroidal anti-inflammatory drugs (NSAIDs) may also be taken to reduce the pain.
A moderate wrist sprain may need to be immobilized using a splint to prevent moving the wrist and aggravating the injury. A severe sprain may need surgical intervention to repair the torn ligament fully.
Physical therapy rehabilitation is also important, which will provide exercises to improve healing, prevent reinjury, restore motion and function, and avoid excessive joint stiffness.
Treatment for wrist fractures depends on the type and location of the fracture. Closed, partial, and extra-articular fractures often heal faster since fewer structures are damaged.
Usually, they require immobilization using a splint, a cast, or a brace to allow the bones to heal in their proper alignment. Intra-articular, open, and comminuted fractures often require surgery to stabilize the bones and correct their alignment.
After surgery, individuals will also need to undergo physical therapy rehabilitation to strengthen the muscles, improve joint flexibility, and prevent reinjury.
The wrist is an intricate joint complex that connects the hand to the arm. It is composed of the ends of the radius and ulna (the bones of the forearm), eight small bones (carpal bones or carpus), and the ends of the 5 metacarpal bones (bones of the fingers).
The larger bone on the same side of the thumb is the radius, and the smaller ones on the same side of the little finger are the ulna; together, they form the distal radioulnar joint.
The carpus is composed of the proximal and distal carpal bones. The proximal carpal bones are those nearest to the forearm bones: the scaphoid, lunate, triquetrum, and pisiform; and the distal carpal bones are those nearest the fingers, which are the trapezium, trapezoid, capitate, and hamate.
The wrist consists of multiple joints that move relative to each other. The area where the radius meets the proximal carpal bones is called the radiocarpal joint.
This is the main joint of the wrist. The area where the proximal and distal carpal bones meet is called the midcarpal joint. The area where the distal carpal bones and metacarpal bones connect is called the carpometacarpal joint.
The wrist allows the hand to move in several directions, such as bending or moving up and down, side to side, and thumb rotation. It also transfers force from the arm to the hand and provides the hand with flexibility and strength.
Dr Aarti is an MBBS (Bachelor of Medicine and Surgery) from Baroda Medical College (The Maharaja Sayajirao University, Baroda). Dr. Aarti has also completed her Masters of Medical Science and Technology from the prestigious Indian Institute of Technology, Kharagpur.