The wrist is most commonly fractured by falling on an outstretched hand (FOOSH). You can fracture one of the long forearm bones (most commonly the radius) or one of the smaller wrist bones (carpal bones) such as the scaphoid. If you do sustain a FOOSH and have immediate wrist pain and an inability to put weight through the hand or move the wrist, along with immediate swelling, it’s likely you have fractured your wrist and you should seek medical assessment.
A Colles (radius) fracture is the most common wrist fracture and often displays a ‘dinner fork’ deformity meaning that the back of your wrist resembles a fork turned downwards. This may treated by immobilisation or surgical repair. Physiotherapy will commence after your orthopaedic surgeon has told you that the fracture has united and rehabilitation can begin.
A fracture of the scaphoid bone is less symptomatically severe as a Colles fracture. This bone is found at the base of the thumb. The reason a fracture of this bone is somewhat infamous is because not all scaphoid bones heal well after fracture. The blood supply to this bone can be compromised by fracture, leading to crumbling of the bone over time (avascular necrosis) which leads to longer term problems with the wrist. For this reason, it’s extremely important that this fracture is identified early and treated effectively.
Tendon injury at the Wrist/Hand A common overuse injury that occurs at the wrist is called deQuervain’s tenosynovitis. It is caused by repetitive activity of the long tendons that control thumb movement and leads to pain and swelling over this tendons at the thumb side of the forearm. Symptoms include pain and swelling over the tendons and maybe even a crunchy sensation over the tendons as the thumb moves (crepitus).
Musicians e.g. guitarists, chefs and office workers are all prone to this injury. A thorough assessment is needed to work out why the overuse injury occurred so that training or work practices can be changed to prevent future episodes. Treatment may involve non-steroidal anti-inflammatory medication, icing, manual therapy (massage) and exercise.
