A broken wrist is a fracture of the bones just above the palm, most often the lower end of the radius (a forearm bone). It usually happens in a fall onto an outstretched hand. Doctors call this a distal radius fracture. It is one of the most common fractures, especially in older people and in children. A broken wrist is treated with a cast or with surgery, and rehabilitation is then needed to bring back movement and grip strength. Kaloyan Zarkov works with patients after a broken wrist at the practice in the Lozenets district and at home.
Symptoms
- Severe pain in the wrist straight after the fall.
- Swelling and bruising that quickly increase.
- The wrist looks deformed if the pieces of bone have shifted.
- Pain when you move the wrist, grip something or lean on the hand.
- Numbness or pins and needles in the fingers.
A fracture where the bone hasn’t shifted sometimes hurts less and looks like a sprain. So after a fall onto the hand, if the wrist is swollen and hurts when pressed, you need an X-ray. After the cast comes off, the wrist is usually stiff and the grip weak. The hardest things are turning the palm up and gripping tightly.
Why it happens
- A fall onto an outstretched hand: on an icy pavement, on stairs, from a slip.
- Sports with falls: cycling, skiing, snowboarding, skating, football.
- Bones that weaken with age (osteoporosis), so that even a minor fall can break the wrist.
- A direct blow or a road accident.
The fracture is confirmed by X-ray. The orthopaedic doctor decides how to treat it: with a cast or a splint if the bone is in place, or with surgery using a plate and screws if the pieces have shifted. Sometimes a displaced bone can be put back in place without surgery. The orthopaedic doctor also decides how long the cast stays on. This is usually a few weeks, depending on the type of fracture and your age.
How we treat it
Rehabilitation starts right after the cast comes off. Until then, it’s important to move the nearby joints that aren’t in the cast: the fingers, the elbow and the shoulder. Bring the discharge summary from the hospital, your X-rays and the orthopaedic doctor’s instructions. Kaloyan checks how far the wrist moves, your grip strength and the swelling. The doctor’s timelines are always followed, and when needed Kaloyan contacts the orthopaedic doctor.
The foundation is kinesitherapy for injuries (exercise and manual therapy), and the work goes in stages. First come device-based physiotherapy and manual therapy, that is, Kaloyan loosening the wrist with his hands. With Combined physiotherapy, Kaloyan chooses the devices that suit you. For the wrist these are usually electrical currents, ultrasound and an infrared lamp. Then come passive-active movements: you move the wrist yourself, and Kaloyan takes the movement further than you can on your own. Last are the active exercises for grip strength, for turning the palm and for the movements you need at work.
If the fracture was operated on, the work is post-operative rehabilitation within the surgeon’s timelines. If you’re older and getting to the practice is hard, Kaloyan can come to you with home visits. You leave with a few exercises for home, shown and explained. Usually 5–10 sessions are needed, depending on the fracture and how long the wrist was immobilised.
What you can do yourself
- While you’re in the cast, move your fingers, elbow and shoulder several times a day.
- When you rest, raise the arm above the level of your heart to reduce the swelling.
- Don’t carry anything heavy with that arm until the orthopaedic doctor allows it.
- After the cast, use the hand for light everyday tasks without forcing through pain. Kaloyan will show you the exercises that suit you.
When to see a doctor first
See a doctor first, or call your orthopaedic doctor, if:
- your fingers are numb, cold, pale or blue, especially under the cast;
- the cast feels tight and the pain and swelling get worse instead of easing;
- the wrist looks deformed after the cast comes off;
- the wound after surgery is red and warm, leaks fluid, or you have a temperature;
- you’ve fallen again or knocked the wrist.
