Wrist Fractures

A wrist fracture — specifically a fracture of the distal radius, the lower end of the larger forearm bone — is one of the most common fragility fractures. It is often the first fracture a person with osteoporosis experiences, and it should be taken seriously as a warning sign of underlying bone fragility.

How Wrist Fractures Happen

The most common mechanism of a distal radius fracture is falling on an outstretched hand — an instinctive reaction to a fall where the hand is put out to break the impact. The force travels up through the wrist and fractures the distal radius.

In a young person with healthy bones, this force would rarely cause a fracture. In someone with osteoporotic bone, the weakened structure cannot withstand the impact, and the bone breaks.

Symptoms

After a fall, symptoms of a wrist fracture include:

• Immediate pain in the wrist, which may be severe
• Swelling and bruising
• Visible deformity (the wrist may appear bent out of shape)
• Difficulty or inability to use the hand normally
• Tenderness when the wrist is touched

X-ray is used to confirm the fracture and assess whether the bones have shifted (displaced) or remain in alignment.

Treatment

Treatment depends on the severity and displacement of the fracture:

• Cast (plaster or synthetic): Used for non-displaced or minimally displaced fractures. Typically worn for 4–6 weeks.
• Surgery: Required for significantly displaced fractures; usually involves the insertion of a metal plate and screws to hold the bones in the correct position. Recovery is generally faster with surgery in younger, more active patients.
• Physiotherapy: Recommended after cast removal to restore strength, flexibility, and function in the wrist and hand.

Recovery

Most people recover reasonable wrist function after a distal radius fracture, though full recovery can take several months. Some residual stiffness or weakness may persist, particularly in older adults.

Activities like driving, writing, and fine motor tasks will be limited during the early weeks. Occupational therapy advice may be helpful if daily activities are significantly affected.

The Critical Next Step: Bone Health Assessment

A wrist fracture over the age of 50 is classified as a fragility fracture and should trigger an automatic assessment of bone density. Research consistently shows that people who fracture a wrist are at significantly elevated risk of a subsequent hip or vertebral fracture — often within the next few years.

Specifically, a wrist fracture approximately:

• Doubles the risk of a subsequent hip fracture
• Significantly increases the risk of a vertebral fracture

Despite this, large-scale studies show that less than 20% of people who sustain a wrist fracture go on to have a DXA scan, and very few are started on bone-protective treatment.

If you have had a wrist fracture and have not been assessed for osteoporosis, please raise this with your GP. This gap in care is preventable — and the consequences of a subsequent hip fracture can be devastating.

Secondary Fracture Prevention

After a wrist fracture, secondary prevention involves:

• DXA scan to assess bone density
• FRAX score to assess 10-year fracture risk
• Starting bone-protective medication if appropriate
• Ensuring adequate calcium and Vitamin D
• Exercise programme to maintain and build bone strength
• Falls prevention assessment and measures

More information on the steps after a fracture is available on our After a Fracture: What Next? page.