A carpal fracture is a break to one of the 8 small carpal bones in the wrist. A direct impact, such as a fall, usually causes this type of fracture, and symptoms include wrist pain, swelling and tenderness. As with all fractures, medical help should be sought. The wrist being in a cast is usually enough to repair the fracture, but surgery may be needed for more complex breaks.
Carpal fracture symptoms
Symptoms of a fractured carpal bone in the wrist generally include sudden pain with rapid swelling and bruising which develops over a period of time. The wrist will be tender to touch and painful when trying to move it. Other more subtle symptoms may be present depending on which of the wrist bones is fractured and other damage. Any tingling or numbness may indicate nerve damage.
Carpal fractures occur as a result of a direct impact on the wrist. Usually, this is a fall onto the hand. The exact position at impact dictates which bones are fractured. Carpal fractures account for 18% of all upper limb fractures. Of these, the most common is a scaphoid fracture, followed by a triquetral fracture.
Treatment of carpal fractures
If a fracture is suspected, seek medical attention. An X-ray of the wrist is used to confirm the diagnosis. In many cases, carpal fractures are simply immobilized in a cast for 4-12 weeks. The scaphoid may require a very lengthy immobilization period due to its poor blood flow.
However, in more complex cases, surgery may be required. Fractures where the bone is in more than 2 pieces, or where the fractured fragment is displaced are the most common reasons for surgery. Surgery is undertaken to realign the bone fragments and fix them in place with pins. The wrist is then cast as above. Scaphoid and lunate fractures most frequently require surgery.