How to Recognize and Treat a Broken Wrist

Broken wrist
Broken wrist from a skiing accident. (c) Tara Fontana

Nobody denies that a broken wrist is a very painful injury. However, as bad as they feel, they're rarely life-threatening emergencies. In many cases, there's not much you can do to help at home. This is going to require a trip to the emergency department (or at least to a clinic that has the ability to take x-rays).

The following steps will help you learn to recognize a broken wrist and to decide how to take care of it.

Signs and Symptoms

Here's what to look for to tell if the wrist is broken. You don't have to see all of these, but the more you see, the bigger the chance that the wrist is busted.

  • Pain (almost always present)
  • Swelling
  • Bruising
  • Deformity (wrist appears misshapen)
  • Numbness or tingling
  • Broken skin with bone visible
  • Limited mobility of the wrist

Treatment

  1. Safety first! Make sure the patient is in a safe location. It is more important to worry about rescuer and patient ongoing safety than to worry about one broken wrist.
  2. Control the bleeding.
  3. Look for other injuries. If a patient shows signs of injury to the head, neck, or back, DO NOT move the patient.
  4. Cover any broken skin with sterile dressings. If needed, the wound can be rinsed; try to use sterile water or saline solution. Open wounds may require stitches.
  5. If an ambulance is responding, have the patient remain still and wait for the ambulance. Proceed to step 9 (ice on the break).
  6. If an ambulance is unavailable, it may be necessary to splint the broken wrist. Before splinting, check circulation, sensation, and motion.
    1. Check circulation by comparing the color and temperature of the injured wrist against the uninjured wrist.
    2. Check sensation by asking the patient which finger you are touching.
    3. Check motion by having the patient wiggle his or her fingers.
  7. To splint a broken wrist, follow the steps for splinting a broken arm. Be sure to immobilize the hand. Any movement of the hand will result in pressure on the wrist. Do not wrap the wrist too tight.
  1. After splinting, recheck circulation, sensation, and motion.
  2. Put ice on the break to reduce swelling. Put a sheet or towel between the ice and the skin to prevent frostbite. Leave the ice on for 15 minutes, then remove the ice for 15 minutes. There is an ongoing discussion about the best ways to handle joint injuries, and RICE (rest, ice, compression, elevation) might not be the best option. In this case, however, some of the alternatives won't work, so ice is probably best. 

Tips

  1. Remember, DO NOT move a patient with suspected head, neck, or back injuries unless it is to keep rescuers or the patient safe.
  2. Always practice universal precautions and use personal protective equipment whenever you may come in contact with blood or body fluids.
  3. Call 911 for a leg broken above the knee, a broken hip, a broken pelvis, a neck or back injury, or a head injury. It is still acceptable to summon an ambulance for a broken wrist, but try to call on the ambulance agency's non-emergency line if known.
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