How Long Does it Take for Broken Wrist Bones to Recover & Heal?
The whole reason I wrote this article is that I broke both my wrists in a terrible accident in 2007 and found very little information online about broken wrists. I decided to write about what happened to me, in order to help other people in my situation! I hope you find this useful. You can read all about my story below, but first, some information about broken wrists.
Types of Wrist Fractures
The wrist is one of the most commonly broken bones. In patients under 65, the wrist is the most common bone to break.
Seventy-five percent of wrist injuries are fractures of the distal radius and ulna. Distal means the end of the bone closest to the wrist. The eight carpal bones (the bones between the arm bone and the hand) are injured less frequently.
In general, there are four main kinds of fractures which are:
- Simple or closed fractures: an easily treated break with little damage to the surrounding tissue.
- Compound or open fractures: a complicated break that also damages the surrounding skin.
- Comminuted: a comminuted fracture means the bone has broken into several pieces. Note: This is the kind of fracture that I had!
- Greenstick: this type is usually most common in children. Greenstick is a type of fracture where the bone is bent but not broken.
Hairline fractures are minor cracks to the bone and only show up on an X-ray. An impacted fracture is when the ends of bones are driven into one another.
Wrist fractures are most common in children and young adults, especially if they're involved in risk-taking activities. They also become common as people get older, when we more likely to fall or suffer from osteoporosis, which increases the likelihood of breaking a bone.
It’s also true that this kind of fracture can sometimes save lives! If I had landed in any other way when I fell, I probably would have broken my neck. In some ways, my wrists were the parachute that softened the fall, though at a fairly big cost!
Usually you know if you've broken your arm or wrist bone because it will be extremely painful.
If it's a clean break, you may have heard a snap or a grinding noise during the accident. The bone can break straight across, diagonally, or in a spiral pattern. In severe cases, the bone may break into many pieces (comminuted), stick out at an angle, or poke through the skin (open or compound fracture).
Some things to look for if you think you may have broken your wrist are:
- Swelling or tenderness around the injured area
- Bleeding if the bone has damaged the tissue and skin
- Pain, especially when flexing the wrist
- Your wrist looks bent or crooked
- Your wrist, arm, or hand is numb
- Your fingers are pale
Presence of these symptoms is not a guarantee that there’s a fracture. A sprained wrist can feel similarly and an X-ray is the only way to find out what happened.
If you’ve suffered an injury to your arm or wrist that has lasting pain, you should go to a doctor to have X-rays taken. It might only be a sprain, but it’s better to be safe than to risk more injury.
What to Do
- Don't eat or drink anything if you think you've broken your wrist, as you may need a general anaesthetic (be put to sleep) to allow doctors to realign the bone. This process can be very painful to do so while you're awake.
- A sling will help stabilise the arm while you're on the way to the hospital. The sling should go under the arm and then around the neck. Don’t try to straighten your wrist.
- Apply an ice pack to the injured area (try a bag of frozen peas wrapped in a tea towel). Ice can help reduce pain and swelling.
- If the injury is to a child, try to find someone to drive and someone else to support and comfort the child.
What to Expect from Treatment
A broken arm or wrist treatment differs depending on how bad the injury is. Here's what will happen as you go through the process:
- A doctor will give you painkillers and then fix a splint to the arm to secure it in position and prevent further damage.
- An X-ray will be taken of the arm to see what kind of fracture it is. Even hairline fractures should show faintly on X-ray.
- A simple fracture where the bone remains aligned can be treated by applying a plaster cast. This holds the broken ends together so they can heal. You should be provided with painkillers to take home and information on how to look after your cast, and you’ll probably make an appointment to attend a fracture clinic so specialist orthopaedic doctors can take over the care of your fracture.
- With more severe arm or wrist fractures, the bones can become misaligned (displaced). If the bone is not realigned (reduced), the bones will not heal well. Doctors can use a technique called 'closed reduction' to pull the bones back into position.
- Local or regional anesthetic will be used to numb the arm (this is rarely used in children), or you will be put to sleep using a general anaesthetic. If doctors are happy with the bones' new position, you may be treated with a plaster cast and regular follow-up appointments and X-rays.
- Certain fractures are best treated with surgery to realign and fix the broken bones (as in my case because it was so severe). This includes displaced fractures, fractures involving a joint, and open fractures. Surgeons can fix bones with wires, plates, screws, or rods. This is called open reduction and internal fixation (ORIF). Any metalwork is usually not removed unless it becomes a problem.
- In rare cases (like mine!) an external frame is used to hold the broken bones, known as an external fixator.
- After most surgeries, a plaster cast is applied to protect the wrist. A sling may also be provided for comfort. If you have surgery, you will usually be able to go home within a day or two.
Helping a Broken Wrist Heal
You might also want to take these steps to help hasten healing along:
- A splint, which you might use for a few days to a week while the swelling goes down; if a splint is used initially, a cast is usually put on about a week later.
- A cast, which you might need for six to eight weeks or longer, depending on how bad the break is (you might need a second cast if the first one gets too loose after the swelling goes away.)
- Regular X-rays to make sure your wrist is healing normally
- Elevate your wrist on a pillow or the back of a chair above the level of your heart for the first few days. This will ease pain and swelling.
- Ice the wrist. Do this for 15-20 minutes every two to three hours for two to three days. Be careful to keep the splint or cast dry while icing.
- Take over-the-counter painkillers. Ask your doctor about nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or aspirin (except for children). They can help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your doctor specifically says otherwise, as this may delay healing.
- Practice stretching and strengthening exercises of the fingers, elbow, and shoulder if your doctor recommends them.
- Most the time, these treatments will be enough. But sometimes (as in my case) people with a broken wrist need surgery. Your doctor might suggest this if the bone is not likely to heal well in a cast. Sometimes, pins, plates, screws, or other devices are needed to hold the bone in place so it can mend.
How Long Will Healing Take?
Generally, recovery for adults takes about 6-8 weeks (shorter for children and longer for elderly). Everyone's situation is different. My recovery took longer than most (obviously) due to the severity of my injury.
In general though, here's what you should expect:
- The plaster cast will stay on until the bone has healed, but the exact length of healing time depends on the type of fracture, whether it has damaged the surrounding tissues, and the age of the patient.
- A young child who broke his or her wrist will need to wear a cast or removable splint for just two to three weeks. For older people, a wrist injury can take a lot longer to get back to normal and stiffness is extremely common.
- Be sure to follow instructions on how to take care of your cast. Most importantly, don’t get it wet! The orthopaedic doctors will decide when you can take the cast off and when you can return to normal activities or work.
- Your arm is often stiff and weak after being in a cast. Physiotherapy can be useful to help build up strength in the arm muscles and restore full movement, as in my case. However, this is rarely needed for children (guess I’m not a kid anymore!)
- There’s a higher chance of re-breaking or cracking the bone once the plaster is removed is increased, especially in children, so kids especially should avoid trampolines, bouncy castles, soft play areas and contact sports for a further two to three weeks to be safe.
- Also, you shouldn’t drive in a cast. Talk to your doctor about when you can drive again.
Fracturing the Scaphoid Bone
The scaphoid bone (also called the navicular bone) is one of eight carpal (wrist) bones. These small bones are the ones responsible for the complexity and delicate movements of our hands. The carpal bones are located between the forearm and hand bones.
The scaphoid sits below the thumb, and is shaped something like medium sized cashew.
Unlike other bones, the scaphoid bone has a retrograde blood supply. This means that the blood flow originates in a small vessel that enters the most distant part of the bone and flows back through the bone to provide nutrition to the bone cells.
The pattern of blood supply in the scaphoid presents a problem when it's fractured. Because of its blood supply system, a scaphoid fracture can sever this blood flow and stop the delivery of necessary oxygen and nutrients to the bone cells.
In short, fractured scaphoid bones sometimes have a hard time healing themselves. Thus, healing can be slow or may not heal at all.
Symptoms of a scaphoid fracture:
A scaphoid fracture is the most common type of carpal bone fracture, accounting for 79% of all carpal fractures. They occur most commonly from falls, which is how I experienced it.
The symptoms of this kind of fracture are pain on the thumb side of the wrist, swelling in that area, and difficulty gripping objects.
Many patients scaphoid fracture can be misdiagnosed with a wrist sprain, but diagnosis is difficult because x-rays taken right after the injury may show no abnormality.
In my case, it wasn’t a problem because of the severity of the fracture. However, even six months after surgery, I still had pain in my right thumb whenever I grabbed something.
When I Can Resume Normal Activities?
Everyone wants to know when and if they can return to their former activities after suffering from a broken wrist. This is a great question which seems simple but actually has a complex answer.
Most patients do return to all of their former activities, but what happens in your case depends on the nature of your injury, the kind of treatment you and your doctors decide on, and how your body responds to the treatment.
You’ll need to discuss your case with your doctor for specifics, but in general most of the following are true:
- Most patients have their cast taken off at about six weeks.
- If recommended by the doctor, patients will start physiotherapy within a few days or weeks after surgery, or right after the last cast is taken off.
- Most patients will be able to resume light activities such as swimming or working out the lower body within a month or two after the cast is taken off, or after surgery.
- Most patients can resume vigorous physical activities, such as skiing or football, between three and six months after the injury.
- Almost all patients will have some stiffness in their wrist, which will generally diminish in the month or two after the cast is taken off or after surgery. Wrist flexibility will continue to improve for at least two years (this is for adults).
- You should expect your recovery to take at least a year, and most will still feel some pain during vigorous activities for about that long. You should also expect residual stiffness or aches for two years or possibly permanently, especially for high impact injuries (such as motorcycle crashes), or if you are over 50 or have some osteoarthritis.
- The good news is that the stiffness is usually minor and may not affect the overall function of the arm. Remember that these are general guidelines and may not apply to you and your fracture. Ask your doctor for specifics in your case.
Waiting for Your Wrist to Feel Better
Of course, what you really want to know is when you can get back in the game after breaking your wrist. There's no easy answer.
Here are some things to keep in mind during recovery from a broken wrist:
- It might take eight weeks or longer for your wrist to heal. More severe breaks may not fully mend for six months. You and your doctor will decide when you are fully recovered.
- Don't rush back into your usual activities too soon. If you start working out before your wrist is healed, you could cause more serious damage.
- You may still have discomfort and stiffness in your wrist for months, or even years, after the injury.
- Follow your doctor's instructions for taking care of your cast. Remember that casts cannot get wet.
- See your doctor if the pain or swelling keeps getting worse after you get a cast or if you experience numbness in your fingers.
My Broken Wrists
In July 2007, I was on a mountain biking trip in the French Alps and fell from the balcony of the second floor of a building. Unfortunately it wasn’t as exciting as a bike crash! And no, I didn't try to kill myself! (in case you were wondering).
After I fell, I had to get up all by myself and go upstairs to go back to the second floor where my friends were. I still don’t know where I found the strength to search for my friends and get their help. I guess my love for life certainly helped!
When I finally reached my friends, they called the paramedics and I was taken to the hospital right away. Well...almost right away. We actually had to stop twice to get some money from an ATM since the ambulance would only take me to the hospital after I paid for the service.
Due to the severity of the fractures, I had to be operated on as soon as I got to the hospital.
During this surgery (the first of three), doctors fixed both my wrists with titanium plates and screws, and they also put an external fixation on my right wrist. This external equipment was attached to both the radius and forefinger metacarpal bones by four screws, two in each bone.
Back in Portugal (where I’m from), the external fixation was removed two months after the operation. They took it out without any anesthesia which made it an unforgettable moment for me (as in it was extremely painful).
At this point, I started daily physiotherapy sessions and immediately began to see good results.
One week later, I went to hospital again. This time it was to have a little spike that the doctor had put in removed because it was starting to push through my skin. I also had no anesthetic this time and it was pretty painful, but by now I was learning how to enjoy it!
X-rays After the First surgery
That which does not kill us makes us stronger.— Friedrich Nietzsche
Almost 7 months after the accident, I had to be operated on yet again to remove the titanium plates from both wrists and get a new on my right wrist to keep it from moving incorrectly. In order to allow the right hand to rotate, they also cut the distal end from my right cubitus bone. This was my third surgery. Not fun!
Even though I was much better, I still needed at least one more operation to have my left wrist put back in place. That surgery, unfortunately, could only happen when I got some significant time off work.
Yes, that’s right—I’d be spending my next vacation in the hospital.
In October 2009, I went through that surgery, which I hoped to be my last, and my surgeon believed that my left wrist would be able to regain its mobility after correcting its position.
This time I only had local anesthesia which allowed a much faster recovery, and I started moving my fingers by the end of the day. It also allowed me to watch the entire process without any pain. However, it did take more than two hours and I almost fell asleep during the surgery...
The operation team decided to add two titanium plates to my wrist and put it back into its natural position. This by itself made a big difference and I could finally grab my bicycle`s handlebars.
The bad news is that it did not improve my wrist mobility, but I had been expecting this. In the last appointment before the surgery, I even suggested to my doctor that he completely secure my wrist like he’d done with my right one, but he told me there was a chance of improvement with the left one.
Unfortunately, I still don´t have good quality digitalizations of the X-rays because they never gave me the original ones. The pictures below were digitized from a paper copy, so I apologize for the poor quality.
Four years after the accident, I can work, write, ride my bike, and do normal, everyday tasks.
If I’m being completely honest, however, I can’t do everything I did before. On the other hand, now that I’ve had to re-learn some things, I do them even better!
X-ray from right wrist after the last surgery
After breaking my wrist, I searched for help and information online from people who’d had similar experiences but found very few people sharing their broken wrist stories.
I hope this hub helps other people going through the same kind of injury. Writing it down and sharing it with everybody certainly helped me debrief the experience.
I hope this helped you as you're recovering from a broken wrist. It does get better :) Feel free to leave some of your experiences and advice in the comments section!