Hand & Wrist

Hand & Wrist Fractures

Hand and wrist fractures are among the most frequent orthopedic injuries seen across all age groups, from young athletes to older adults sustaining fall-related injuries. Because the hand and wrist are mechanically complex — with 27 bones, multiple joints, and an intricate network of tendons and ligaments — even fractures that appear minor on X-ray can result in lasting stiffness, pain, or loss of function if not properly evaluated and treated. At Maryland Orthopedic Specialists, our hand surgeons provide expert assessment of all hand and wrist fractures and guide each patient toward the most appropriate course of care, whether that means a well-fitted cast or precise surgical fixation.

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What is hand & wrist fractures?

A hand or wrist fracture is a break in any of the small bones of the hand or the bones forming the wrist, usually from a fall, crush, or sports injury. Symptoms include pain, swelling, bruising, and difficulty gripping. Treatment ranges from splinting to surgery depending on the fracture.

Treatment options

Non-Operative

Stable, minimally displaced fractures of the wrist or fingers are treated with a cast, splint, or buddy taping to the adjacent finger, which holds the bone in place while it heals. This approach works well when the fracture is in a good position and the joint surface is not involved.

Surgical Procedure

Distal Radius Fracture Fixation (ORIF)

Volar locking plate fixation of a displaced distal radius (wrist) fracture, restoring radial length, inclination, and articular congruity. Allows early finger and wrist motion to begin during the healing period.

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Frequently Asked Questions

My X-ray at the ER looked fine, but my wrist still hurts weeks later. What should I do?
Some fractures — particularly scaphoid fractures — are invisible on initial X-rays. Persistent wrist pain after a fall warrants re-evaluation, which may include MRI or CT scanning.
Will I need surgery for a Boxer's fracture?
Most fifth metacarpal neck fractures are treated successfully without surgery, provided the angulation is within acceptable limits and there is no rotational deformity. Our surgeons will show you what "acceptable" means on your specific X-ray.
How long before I can return to sport after a distal radius fracture?
Most athletes return to non-contact sport by 8–12 weeks and contact sport by 3–4 months, depending on fracture severity and fixation type.
What causes post-traumatic arthritis?
Arthritis develops when the joint surface heals with residual step-off or gap greater than 1–2 mm, or when altered mechanics accelerate cartilage wear. Anatomic surgical restoration of the joint surface is the best prevention.
Will I develop stiffness in my hand or wrist after a fracture, and how do I prevent it?
Some degree of stiffness is common after any hand or wrist fracture due to immobilization, swelling, and scar tissue formation. Early mobilization of uninjured fingers during cast or splint treatment is important to minimize stiffness. Formal hand therapy, including active range-of-motion exercises, scar management, and progressive strengthening, is a cornerstone of recovery and significantly reduces long-term stiffness. At MOS, your treatment plan will include hand therapy referral as soon as it is safe to begin movement so that you recover the best possible function.

Meet the specialists

Peter G. Fitzgibbons, MD

Peter G. Fitzgibbons, MD

Hand Surgery · Orthopedic Surgery

Meet Dr. Fitzgibbons

Related conditions

Medically reviewed by Peter G. Fitzgibbons, MD, MD
Last reviewed May 1, 2026

References

  1. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. Journal of Hand Surgery (American Volume). 2001;26(5):908–915. doi:10.1053/jhsu.2001.26322
  2. Lichtman DM, Bindra RR, Boyer MI, et al. Treatment of distal radius fractures. Journal of the American Academy of Orthopaedic Surgeons. 2010;18(3):180–189. doi:10.5435/00124635-201003000-00007
  3. Ochen Y, Peek J, van der Velde D, et al. Operative vs nonoperative treatment of distal radius fractures in adults: a systematic review and meta-analysis. JAMA Network Open. 2020;3(4):e203418. doi:10.1001/jamanetworkopen.2020.3418
  4. Kollitz KM, Hammert WC, Vedder NB, Huang JI. Metacarpal fractures: treatment and complications. Hand (New York). 2014;9(1):16–23. doi:10.1007/s11552-013-9562-1
  5. Meals C, Meals R. Hand fractures: a review of current treatment strategies. Journal of Hand Surgery (American Volume). 2013;38(5):1021–1031. doi:10.1016/j.jhsa.2013.02.017