Broken Wrist in Kids

Your child’s wrist is made up of the two bones of the forearm — the radius and the ulna — and eight carpal bones. A broken wrist is when one or more of these bones break (also known as a fracture).

Two of the most common types of wrist fracture in children are:

• Distal radius fracture, a break in the radius close to the wrist
• Scaphoid fracture, a break of the carpal bone that sits just below the thumb

• Buckle fracture: The bone is cracked but not broken. This is the mildest type of fracture and may not cause severe pain.
• Non-displaced, simple fracture: The bone is broken but the two ends remain aligned.
• Displaced fracture: The bone has broken and the two ends have separated.
• Growth plate fracture: The fracture extends into the area at the end of the bone where growth takes place.
• Interarticular fracture: The fracture extends into the joint.

While many falls cause immediate pain, severe pain or pain that lingers for more than a day is often a sign of a broken wrist. Broken wrists often have swelling or bruising, and it may be difficult to move or use the affected wrist and hand.

Any wrist fracture in a child requires prompt medical attention to ensure the bones heal properly. Seek medical care if your child has any of these symptoms of a fractured wrist:

• Severe pain
• Swelling
• Bruising
• Wrist that looks bent or out of alignment
• Numbness or tingling
• Trouble moving fingers

Any sort of trauma to the wrist can result in a wrist fracture, including:

• Falls: Falling onto an outstretched hand, for instance:
  • Falls from trampolines, bouncy houses, and playground equipment
  • Falls from snowboards, bikes, and scooters
• Sports injuries: Taking a direct hit in sports like football, hockey, soccer, or lacrosse

At Boston Children’s Hospital, one of our orthopedic specialists will examine your child’s wrist and order an X-ray to determine if the wrist is broken. Because some fractures — especially scaphoid fractures — are not always visible on X-ray, we may also order a CT scan or MRI for a more detailed view of the bone and tissues around it.

• Casting: Most children with a fractured wrist need to wear a cast to keep the bones immobile while they heal.
• Bracing: Some very stable fractures (like buckle fractures) can be treated in a brace.
• Reduction: If your child has a displaced fracture, one of our specialists will move the ends of the broken bone back into alignment through a procedure called a reduction.
• Surgery: Your child may need orthopedic surgery if one or more of their bones is broken in several places, or if the alignment is not ideal. In this case, our surgeons may use rods, screws, or other implants to further stabilize the bone and support proper healing.

Your child’s wrist may be sore for a few days or a week after the injury. You can use acetaminophen (Tylenol) or ibuprofen (Advil) to treat the pain. Always talk with your provider about allergies before giving your child over-the-counter medications.

To reduce pain and swelling, prop your child’s arm up on pillows so that their wrist is above their elbow, and their elbow is above their shoulder.

If your child had surgery, we may prescribe a small amount of stronger pain medication to manage pain for the first couple of days.

Your child will probably need to wear a cast for four to eight weeks, depending on the type of fracture. Some fractures can even take three months to heal.

Your child should avoid activities that put them at risk of falling or taking a direct hit to the arm until the bone fully heals.

We typically schedule follow-up visits one to two weeks after treatment to assess how well a patient’s wrist is healing. Over the course of your child’s follow-up care, we’ll also make recommendations about when they can safely return to sports and other activities. If your child had a growth plate fracture, we’ll continue to monitor how their bone is growing over time.

The Orthopedic Urgent Clinic at Boston Children’s Hospital offers access to world-class pediatric orthopedic specialists, X-ray facilities, and cast technicians in Boston, Needham, Peabody, Waltham, and Weymouth. As part of the Orthopedics and Sports Medicine Department, we provide specialized orthopedic care for children, teens, and young adults with fractures and other injuries that need prompt care.

If your child has a severe wrist fracture, we may refer them to our Orthopedic Trauma Program or our Hand and Orthopedic Upper Extremity Program. Both programs include orthopedic surgeons who specialize in repairing complex injuries in growing children, teens, and young adults.

No matter what the condition, our goal is always the same: to help your child regain function so they can reach their full potential.