The most common type of fracture of the wrist joint is a break in the radius bone, known as a distal radius fracture. In fact, a distal radius fracture is often synonymous with the term “broken wrist.”
The wrist is a complicated joint that contains many bones, however, so there is potential for several different types of fractures. This article is a brief guide to some of the more uncommon potential fractures of the wrist.
The wrist contains two rows of small round bones, eight in total, known as carpal bones. Of these, the most frequently fractured is the scaphoid carpal bone, which is near the base of the thumb. Scaphoid fractures are the second most common wrist fractures, after distal radius fractures. Scaphoid fractures can be hard to identify and treat, so prompt diagnosis and care is important.
A Barton’s fracture is a distal radius fracture with the addition of a dislocation in the radiocarpal joint between the forearm and the wrist. A Barton’s fracture can be diagnosed and treated in a similar manner as a distal radius fracture, except it’s less likely that it can be treated with a closed reduction (resetting without surgery) and will probably require surgery.
Chauffer’s Fracture (Radial Styloid Fracture)
The radial styloid is the bulge at the end of the radius bone, close to the base of the thumb. The fracture is usually caused by a direct blow to the radius—in fact, it is named chauffer’s fracture because a wrist strike from the handcrank on early cars would often cause this fracture. Chauffer’s fractures are treated surgically.
Ulnar Styloid Fracture
Running parallel to the radius is a smaller forearm bone, the ulna. It also has a bulge at the end of the bone known as the styloid. The ulnar styloid is the bump that can be seen on the outside of the wrist. This fracture often occurs in conjunction with a distal radius fracture as the result of a fall. It’s not always necessary to treat this fracture, especially if it is at the tip of styloid. If the fracture is at the styloid base and/or there’s a danger it will destabilize the small joint between the radius and ulna bones (distal radioulnar joint), it can be surgically treated.
Other Carpal Fractures
Scaphoid fractures, discussed above, account for approximately 70% of the carpal bone fractures.1 A few other of the eight carpal bones can be prone to fractures as well:
- The triquetrum is the second most common carpal bone to experience fracture. It’s located on the pinky side of the wrist near the ulnar styloid and is often fractured by a fall onto that side of the hand.
- The trapezium is a carpal bone at the base of the index finger’s metacarpal bone. It can be fractured when the index finger is jammed or dislocated.
- The lunate carpal bone sits directly above the radius and is prone to fracture or dislocation during a fall. If a lunate fracture is not treated, it can progress into Keinbock disease (osteonecrosis of lunate).
- Hook of hamate fractures can affect the hamate carpal bone. They are rare and occur most frequently in golfers, baseball, or racket players when their club or bat impacts against the wrist.
Regardless of the type of fracture, a vast majority of wrist injuries are caused by the same action: a fall onto an outstretched hand. Patients who experience a fall or other accident to the wrist and have persistent pain should seek medical attention for diagnosis and treatment.