Wrist fracture

Breaking your wrist

When someone has a broken bone in their wrist they will often notice pain, swelling and be less able to use their hand. There are many different types of bony injuries. While the bones repair, your wrist will be supported in either a splint or plaster cast.

Within the PDF below, see Figure 1: X-ray image of a wrist.

Caring for your broken wrist

A plaster cast or splint is usually kept on for up to 6 weeks. This will help keep the bones in a good position while healing and help ease the pain.

Managing your pain

Your wrist and hand will be painful for several days. Any discomfort can be controlled by taking simple pain relief such as paracetamol. If you have other medical conditions your pharmacist will be able to advise you on suitable pain relief.

Is an operation needed?

In some cases, an operation may be suggested to improve the position of the bones so that they heal in a more natural position. An operation may also be needed to use pins and/or plates to hold the bone firmly while it heals. This option will be discussed with you by a member of the Trauma and Orthopaedic team.

Within the PDF below, see Figure 2: Radius bone with a fracture treated with screws and a plate.

Care of your wrist and hand while in plaster

Reduce the swelling

Your hand and arm may swell because of your injury. Swelling can increase your pain as it puts pressure on the injured parts. It is important to prevent stiffness and keep the unaffected joints moving.

The swelling can be reduced by:

Using a sling for the first 3 to 5 days (see sling leaflet for guidance) and following the advice below.

• Keep your hand raised above the level of your heart as much as possible
• When resting, keep your arm out straight, raised on several pillows
• Every 15 minutes throughout the day, raise your hand up above your head and curl your fingers into a fist, then straighten them (see images below)

Within the PDF below, see Figure 4: Raise your hand & Figure 3: Curl your fingers into a fist

Keep your fingers, thumb, elbow and shoulder moving

In order to keep your uninjured joints healthy, it is important that you keep them moving. This will also encourage the blood supply to your soft tissues and reduce the swelling. Studies have shown that keeping the uninjured parts moving helps speed up your recovery once the plaster has been removed.

Caring for your cast or splint

You should have been given a leaflet about the care of your plaster cast or splint. If you did not receive a copy, please ask a member of staff for a copy or follow the link below:

Care of your cast

Website: www.gloshospitals.nhs.uk/your-visit/patientinformation-leaflets/care-your-cast/

Information on using a sling

Website: www.gloshospitals.nhs.uk/your-visit/patientinformation-leaflets/information-using-sling/

Both types of support should be a comfortable fit. They should be kept dry and not put under heavy strain. Sometimes they can cause rubbing to the skin and a blister may form. This needs to be treated as soon as possible to prevent a more serious wound. If there is any damage to the cast or splint or it becomes loose, please contact the Plaster Room.

While you have a cast on your wrist

Try to use your hand normally for all light activities but avoid getting the cast wet or very dirty.

Brushing hair, dressing, buttons, zips, feeding yourself are all possible with a cast and you can also use your good hand to help if needed. Use your injured hand regularly, for example every hour on the hour. This will help to prevent muscle weakness.

Eat healthily and avoid smoking

Try to eat a healthy varied diet and avoid smoking to help the healing process. Taking Vitamin C, 500 mg daily for the first 6 weeks may also help to reduce the risk of complications.

A high protein diet with lots of fruit and vegetables is proven to help with bone repair.

After the cast has been removed?

If your wrist is swollen or achy, then soaking it in a bowl of warm water will help.

Massage your wrist and towards your elbow regularly with moisturising skin oils or hand cream.

If your hand and arm are swollen then tilt your hand upward on pillows and keep the fingers moving.

You should follow the exercises on this page to keep the joints in your hand, wrist, elbow and shoulder moving.

Exercises

The exercises will help to make sure that your wrist returns to normal when the cast has been removed. All of these exercises should be performed little and often every day.

• Fully bend your wrist. Try to bend it more. Hold for 30 seconds. Repeat 10 times.
• Fully extend your wrist back. Try to bend it more. Hold for 30 seconds. Repeat 10 times.
• Rest your forearm on a table, palm turned up. Alternately turn palm up and down keeping the elbow straight. Repeat 10 times.
• Hold fingers and wrist straight. Bend your hand first towards the little finger and then towards the thumb. Repeat 10 times.
• Make a fist (thumb over fingers). Straighten your fingers and bring them apart. Repeat 10 times.
• Place the palm of your hand on a table. Bring your thumb away from the index finger and then back again. Repeat 10 times.
• With your thumb touch each fingertip, and then slide down the little finger. Repeat 10 times.

Possible complications

All risks or complications can be reduced if you follow the guidance on this page.

A very small group of patients can develop complications after a wrist fracture, including a condition called complex regional pain syndrome (CRPS). Your hospital doctor or therapist will tell you if this has developed. This condition requires early hand therapy which your doctor will arrange.

When to seek advice

If you experience any of the follow please contact the Plaster room, Trauma Clinic or your GP for advice during office hours. Outside of these times please contact NHS 111.

• Increased pain
• Increased swelling in the fingers or arms
• Numbness or pins and needles in the affected arm
• Inability to move your fingers

Contact information

Trauma Service

Tel: 0300 422 5269

Monday to Friday 8:00am to 4:00pm

Email: ghn-tr.glostrauma@nhs.net

Plaster Room

Cheltenham General Hospital

Tel: 0300 422 3148

Monday to Friday, 8:45am to 4:30pm

Gloucestershire Royal Hospital

Tel: 0300 422 8411

Monday to Friday, 8:45am to 4:30pm

Orthopaedic Outpatients

Cheltenham General Hospital

Tel: 0300 422 3147

Monday to Friday, 8:30am to 5:00pm

Gloucestershire Royal Hospital

Tel: 0300 422 8408

Monday to Friday, 8:30am to 5:00pm

Therapy Department

Cheltenham General Hospital

Tel: 0300 422 3040

Monday to Friday, 8:00am to 4:00pm

Email: ghn-tr.physiotherapy@nhs.net

Physiotherapy Department

Gloucestershire Royal Hospital

Tel: 0300 422 8527

Monday to Friday, 8:00am to 4:00pm

Email: ghn-tr.physiotherapy@nhs.net

NHS

Tel: 111