For an active person, a wrist injury might not be as common as a shoulder or knee injury. Wrist injuries can be challenging, though, for competitive athletes or people who play sports requiring wrist motion, like golf and tennis.

In this article, I describe some of the more common traumatic injuries of the wrist.

Wrist injury #1: Distal radius fracture

The radius is one of the long bones in the forearm. A distal radius fracture means that you broke the bone at the wrist. Athletes and non-athletes alike can suffer this injury. An older patient with decreased bone density can suffer a distal radius fracture after a fall on the outstretched hand. A displaced fracture, where the bone doesn’t line up well, usually needs urgent reduction in an emergency department. A nondisplaced fracture can often be treated in a cast. A displaced fracture usually needs surgery to line up the fragments and hold it in place.

Wrist injury #2: Scaphoid fracture

The scaphoid is a bone located on the radial side of the wrist (side closest to the thumb). This bone can be felt at the base of the thumb in an area known as the “anatomic snuffbox” between tendons that move the thumb. A scaphoid fracture often results from a fall on your outstretched hand. Nondisplaced fractures in certain locations can be treated in a cast. A displaced fracture needs anatomic reduction and fixation with a screw. Also fractures in certain locations need surgery even if they are nondisplaced because they have poor blood supply. If a scaphoid fracture doesn’t heal or it heals in a bad position, long-term degenerative changes in the wrist can develop. It is important to diagnose this injury and start treatment quickly to ensure the fracture heals.

X-ray of a scaphoid fracture after surgery
A screw has been placed within the scaphoid across the fracture.

Wrist injury #3: Extensor carpi ulnaris (ECU) subluxation

The extensor carpi ulnaris (ECU) is one of the tendons that crosses the back of the wrist to extend your wrist and fingers. The ECU tendon lies close to the ulnar styloid, the bony prominence on the back and ulnar side of the wrist (side closest to the little finger). A traumatic twisting injury to the wrist can rupture the tissue that holds this tendon in place. You might feel the tendon snap over the ulnar styloid with certain activities. If you have subluxation of the ECU tendon, you might need surgery to repair that tissue and stabilize the tendon.

Wrist injury #4: Hook of the hamate fracture

The hamate is one of the small bones on the ulnar side of the wrist. You can fracture a small portion of this bone when your wrist motion stops suddenly as an object you’re holding hits a hard surface. For example, your golf club unexpectedly hits the ground. Or you check your swing in
baseball, and the base of the bat hits the inside of your hand. X-rays and occasionally CT scans can demonstrate this fracture. Wearing a wrist brace can decrease pain. For some people who continue to have pain, the surgeon can remove the bony fragment.

Wrist injury #5: Triangular fibrocartilage complex (TFCC) tear

The TFCC is a cartilage and ligament structure on the ulnar side of the wrist. You can injure it after a traumatic event or with repetitive use of your wrist. Tennis players often suffer TFCC tears. Arthroscopic surgery to trim out or repair the torn structure is occasionally necessary.

Some of these wrist injuries potentially require surgery. If you injure your wrist, consider seeing an orthopedic surgeon to determine the nature of your injury and plan treatment.

One important point about seeing a doctor or surgeon is worth pointing out. Many orthopedic surgeons and even sports medicine specialists do not perform hand and wrist surgery. It is often helpful to seek out a hand specialist specifically.

Wrist injury causing pain

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