Kid's Wrist Fracture

Wrist fractures in kids are common injuries. The commonly broken bone is the radius bone of the forearm (along the thumb side). Wrist fractures can also involve the ulna bone (small finger side of forearm) or one of the 8 smaller carpal bones within the wrist joint.

Causes

Wrist fractures in kids usually result from a fall onto an outstretched arm.  Monkey bars, playground equipment, scooters, bikes, and sports are common culprits, as they produce higher energy falls that can cause the bone to break.

Diagnosis

Wrist fractures result in pain, swelling, and decreased motion.  Kids will oftentimes have difficulty bending or straightening the wrist, or pain and difficulty rotating the forearm.  More severe wrist injuries can result in the forearm looking deformed or bent. X-rays are essential for a diagnosis.

Treatment

Non-surgical treatment

  • Non-displaced, or stable, fractures can oftentimes be treated in a splint or cast. Splints provide less support than a hard cast, but may be used for minor injuries. Fractures take ~6 weeks to heal, but this can vary based on the location, severity, and age of the child.

Surgery

  • Fractures that have shifted, or “displaced”, are sometimes treated surgically. This can involve reducing, or “setting” the bone, which can then be held in a corrected position with either pins or a cast. Sometimes an incision is required to properly align the fracture.

A. Displaced distal radius fracture in a child.

B. Fracture was aligned and held with temporary pins.

C. After 3 weeks of healing, pins are removed in the office.

D. Fracture has healed 6 weeks after the procedure, activities are resumed.

X-rays of a distal radius “physeal separation”. On the left, the portion of the bone called the epiphysis is not well aligned with the metaphysis. After reduction, the distal radius growth plate is well-aligned - “the golf ball is back on the tee.”


Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.