If you fall and reach out to catch yourself, you may sprain your wrist or even fracture it. Obvious warning signs such as swelling, deformity, or an open wound require medical treatment within 24 hours.

But what if pain is your only symptom?

If pain gets worse with time, you probably need an x-ray, says David Ruch, MD, director of orthopaedic hand surgery at Duke.

“After a couple of days, if pain localizes to one spot, especially one that’s very tender right over the bone, chances are the bone is at least cracked there.”

At clinics such as those in Duke’s Department of Orthopaedic Surgery, doctors may also consider an MRI, which can reveal ligament tears that an x-ray can’t.

“Let’s say the pain persists for six weeks and there’s still no relief. That’s probably a time to consider getting an MRI,” Ruch says. “We want to diagnose ligament tears sooner rather than later because if they’re treated acutely, within six to eight weeks, we can get a good result.”

Otherwise, scarring can develop, leading to irreversible damage and sometimes arthritis.

Treatment Options

Sprains may require only a splint. Some broken bones may be treated with a cast, but both bone fractures and ligament tears are candidates for surgery.

“Depending upon the involvement of the wrist joint, surgeons have become increasingly aggressive about operatively treating these broken bones,” Ruch says.

He especially recommends surgery for younger patients. “We’ve found over the years that many older patients are more tolerant of some loss of function, and they may accept that in order to avoid surgery.”

Those patients may have trouble with tasks that require a strong grip and rotation at the same time, such as opening jars or heavy doors.

At Duke, patients can opt for minimally invasive arthroscopic surgery, which eliminates the need for large incisions. “And we design and use some stabilizing implants that we feel are better than any other devices out there,” Ruch says.

Wrist Fracture Facts

• Broken wrists are the most common fracture in people under age 75.
• Highest rates are among children ages six to 10 and adults over 60.
• Most happen from high-impact injuries such as auto accidents or falls from great heights, or in older adults with osteoporosis who fall and try to catch themselves on an outstretched hand.
• To help prevent injuries, wear a wrist guard during high-risk activities such as rollerblading.