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TIPS FROM THE TRAINER: Wrist fractures: Is it broken or sprained?

TIPS FROM THE TRAINER: Wrist fractures: Is it broken or sprained?

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Many times while playing sports, our athletes fall. Most of the time nothing happens and they get right back up and keep playing.

Sometimes athletes might get up holding their lower arm and come off the field or court because they know something isn’t right. Other times they may keep playing, and after a game or practice, they might complain of pain in their wrist.

How do we know what the injury is or if it is severe?

Typically, if a player comes off the field holding their wrist or arm, something isn’t normal. We can look to check for any deformity. Several types of wrist and lower arm fractures can cause an abnormal look or deformity. If there is a deformity, the arm, hand and wrist need to be splinted, and X-rays should be done.

Fixing this type of fracture can be as simple as casting the arm or as complex as needing to set the bones back in place and put plates and screw or pins in to hold the bones in place. X-rays give the orthopedist a good idea of how they will fix the problem.

Other times determining a fracture is not so simple. Many times, after a practice or game athletes might complain of pain in their wrist. They may have fallen and put a hand down to catch themselves or been hit and braced the blow putting their hands out in front of them to push the opposing player away.

These instances of pain after a competition often result in a wrist sprain. This injury is to the ligaments in the wrist that hold the bones together.

How do we know that there is not a fracture?

Sometimes it is difficult to determine if a fracture is present, as there can be very subtle fractures in the distal bones of the forearm. Nondisplaced fractures of the styloid processes of the ulna or radius can occur. This is the knotted area on either side of the wrist. Usually, this type of fracture will be very tender to touch over the knotted bone. Some swelling might be present in the area as well.

Another type of fracture that happens with our younger athletes is a fracture at the growth plate. These fractures are known as Salter-Harris fractures and are classified from 1 to 5 based on how the fracture goes through the growth plate. Sometimes these are very difficult to differentiate from a sprain.

Like a sprain, the athlete complains of pain at the end of the bones of the lower arm and with movement of the wrist. They might have difficulty holding things or moving the hand and wrist in certain directions. X-rays will be needed to determine if a fracture is present.

A Class 1 Salter Harris fracture might need to be splinted to heal where a higher grade might need to be casted or pinned to hold the bone in place.

The other common fracture in the wrist is a scaphoid fracture. This is a fracture of one of the carpal bones, the small bones that make up the wrist. This bone is located on the thumb side of the wrist and needs special attention if fractured due to a lower blood supply. This lower blood supply could cause problems healing if not taken care of properly.

In all cases of fractures, the diagnosis will come from an X-ray. If there is pain in the wrist area caused by a fall or blow to the area that causes swelling, lack of motion and high pain levels with use, it is best to see your doctor and get an X-ray done to see if a fracture might be present. Healing time for bones is typically six weeks.

If the arm is casted for the entire healing time, some physical therapy might be needed to help with the return of motion and strength. Usually this all comes back quickly, and the athlete can return to their prior competitive form with no adverse effects.

In some sports, the athlete can play with the arm in a cast. This will depend on the sport and position the athlete plays.

As with any injury, if you question the severity, check with a medical professional to get the treatment you need.


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