Injuring your wrists can put a real damper on your day to day life. When it’s hard to do everyday tasks like eating, cleaning, or even using your phone, all you want is some relief. That’s why it’s essential you find out if your wrist injury is due to a sprain or a fracture.
But how do you know the difference?
Well, a common saying is, “I could move it, so I knew it wasn’t broken.” Unfortunately, the reality is that’s it’s not so black and white. You might still be able to move your wrist even if it’s fractured, so this myth only keeps you in pain and injured longer. The truth is the only reliable way to know if you have a sprain or a fracture is to get an exam and an imaging study like an X-ray.
If you find yourself with a wrist injury and you’re not quite sure what the culprit is, read along to learn about the key differences between a sprain and a fracture. Being able to spot the differences and knowing when to seek medical assistance helps get you on the fast track to healing and living the pain-free life you deserve.
Types of Wrist Sprains
Most low-grade sprains are significantly better within 1-2 weeks, whereas fractures stay painful at a similar level for a longer period of time. Sprains are graded based on the degree of injury to the ligament or how far the ligament is pulled away from the bone:
- Grade 1 sprain – A mild sprain where the ligaments are stretched but not torn.
- Grade 2 sprain – A moderate sprain where the ligaments are partially torn. This may require a cast or splint to stabilize the joint. Also, some loss of function may occur.
- Grade 3 sprain – A severe sprain where the ligament is completely torn or detached from the bone. Surgical care may be required.
What Does a Wrist Sprain Feel Like?
Some common symptoms of a sprained wrist include:
- Painful, especially with motion
- Warmth around the wrist
- A feeling of tearing or popping inside of the wrist
- Loss of strength or stability
Types of Wrist Fractures
The type of fracture plays a role in the doctor’s interpretation of the injury and decision making about the best way to treat the fracture. Wrist fractures can be classified a few different ways based on the location and type of break:
- Intra-articular vs. extra-articular – An intra-articular fracture extends into the wrist joint, while an extra-articular fracture doesn’t extend into the wrist joint.
- Displaced vs. nondisplaced – Displaced fractures are when the bones have moved out of place and no longer line up straight. Nondisplaced fractures can be stable as the bones haven’t moved out of place.
- Comminuted – In this type of injury, the bone is broken in several places.
- Compound – This is now called an “open fracture” and is when there is a break or opening in the skin near the site of injury.
What Does a Broken Wrist Feel Like?
Common symptoms of a broken wrist include:
- Severe pain that worsens with movement
- Obvious deformity, wrist appears oddly bent
- Numbness or tingling in fingers
- Difficulty or inability to move the hand or wrist
What’s the Difference Between a Wrist Fracture vs. Broken Bone?
When you hear the words fractured bone or broken bone what you’re really hearing are different terms with the same meaning. A fractured bone and a broken bone are the same. A fracture is a technical terminology a physician uses to describe an injury to the bone, while a broken bone is a common layperson way of describing an injury to a bone.
Some think of a fracture as less severe than a broken bone, but technically that’s not the case. Physicians use words like displaced, malaligned, or angulated to describe a fracture that’s not in its normal (anatomic) position. At the end of the day, a fractured bone and a broken bone are one and the same and can be used interchangeably.
When to See a Hand Surgeon
If you have any suspicions that you may have a fracture, it’s best to make an appointment with your hand surgeon within a few days. This is because the best way to know if you have a fracture is by getting an x-ray. While urgent care can x-ray and splint your fracture, they can miss the subtler injuries which may delay care. You’ll get all the answers you need by seeing a specialist sooner rather than later to avoid further complications.
Here’s how to handle seeing a hand surgeon when you suspect a wrist fracture:
- If your wrist is deformed, bruising is present, it’s severely swollen, or if pain prevents you from moving your wrist normally in any direction it’s time to see a hand surgeon.
- For milder injuries, call your doctor if your wrist symptoms don’t improve within two to three days after your injury.
- See a hand surgeon immediately if you have numbness or trouble moving your fingers.
- You need to go to the ER right away if you have an open fracture (broken or open skin at the site of the fracture).
Diagnosing a Wrist Injury
When you injure your wrist, your doctor will ask you to describe how the injury occurred and perform a physical examination. Common physical tests during the examination could include:
- Inspecting for deformity, bruising, swelling, and lacerations
- Palpating the critical structures to assess the location of the injury
- Testing your joints to assess their stability
Based on the exam, your doctor may then order an x-ray. An x-ray is needed to decipher between a sprain and a fracture in most situations. If the x-ray appears normal but your symptoms are severe and persistent, your doctor may order additional tests such as a CT scan or an MRI. Rarely would a bone scan would be needed.
It’s important to note that fractures of the scaphoid (one of the wrist bones) can masquerade as a sprain. This is because sometimes scaphoid fractures aren’t as painful as distal radius fractures (a forearm bone near the wrist). Your practitioner should check the scaphoid for tenderness and if there’s any suspicion, then special x-rays, a CT scan, an MRI, or early follow up and recheck are necessary.
Treatment for Wrist Sprain
For mild sprains, the RICE protocol is very effective at relieving symptoms:
- Rest – Do not use your wrist for 48 hours. You may need a splint to help.
- Ice – Ice your wrist immediately after injury then for 20 minutes, 2-3 times per day. Never apply ice directly to your skin – remember to wrap the ice in a clean cloth before using.
- Compression – Use a compression wrap or bandage to reduce swelling.
- Elevation – Elevate your arm as often as you can, keeping it above your heart level.
In addition to following the RICE protocol, you may also consider using a nonsteroidal anti-inflammatory drug (NSAIDs) like ibuprofen or naproxen to reduce swelling and pain. Your doctor may also recommend some stretching exercises to help you regain full mobility in your wrist. Furthermore, if your injury requires a splint, you can find these at your local drugstore. Keep in mind that a severe wrist sprain may require surgery.
Treatment for Wrist Fracture
Treatment for a wrist fracture may include a splint, cast, or surgery, depending on the severity and location of the break. A padded splint can be used to give support and alignment to provide much-needed pain relief after an initial fracture. Then, a cast is used to hold fractures that have been set and aren’t unstable.
If the broken wrist is not in the correct position to heal, your doctor may need to reset it with surgery. Using pins, rods, screws, or plates, your fracture is set for proper healing. If the bone is crushed or severely damaged, a bone graft may be used.
Once you’ve had your wrist set with a splint, cast, or surgery, rehabilitation therapy is usually part of the recovery process. This includes hand therapy to recover motion, function, and strength while also preventing your hands from getting stiff. Following through on the recommended therapies reduces your risk of developing arthritis of the wrist joint.4
How Do I Know if I Need Wrist Fracture Surgery?
The following factors are considered by your doctor when assessing if wrist fracture surgery is necessary. If the answer to any of these questions is yes, then your doctor will most likely recommend surgery.
- Are the bones shifted out of position?
- Are the bones fragmented and unstable?
- Is the wrist joint, as a whole, affected by the injury?
Looking for a Hand Surgeon for Your Wrist Injury?
If you have a wrist injury, there’s no need to remain in pain any longer – a hand surgeon really makes all the difference. With the right expertise, diagnosis, and treatment you can get back to doing the things you enjoy quicker.
Don’t spend another minute wondering if a hand surgeon is right for you, make an appointment today by calling (602) 393-4263 or by scheduling online. At your appointment, I, Dr. Vella, will answer any questions you have and help guide you through the treatment of your wrist injury.
Together, we’ll create a tailored approach for your specific needs that gets your wrist healed and most of all, pain-free.