Car accidents, even minor car crashes, can cause wrist injuries, and even minor wrist pain can be a sign of a more severe injury. The wrist injury can occur when drivers or passengers use their hands to brace themselves for the impact from the car crash. Wrist injuries could range from sprains and strains to fractures.
Signs and symptoms of a wrist injury can include pain, swelling, numbness, tenderness, and/or inability to straighten or flex the wrist. Wrist injuries could present with minimal pain or symptoms and because of this, may go untreated or undiagnosed for sometime. People could assume mild wrist pain is a minor sprain and not seek treatment or x-rays. Also, many people may not realize that a car accident can tear ligaments or break bones in the wrist. However, those mild symptoms could result from an unrecognized wrist fracture or severe ligament tear.
Common types of wrist injuries from car accidents include:
Strains and/or Sprains: The bones in the wrist are connected by ligaments, and these ligaments can be pulled, torn or partially torn during a car accident. Sprains can range from mild to severe, depending on the amount of damage. Even a sprain can result in permanent damage and wrist instability if left untreated. Physicians rate the severity of wrist sprains as follows:
- Grade 1 sprain (mild). The ligaments are stretched, but not torn.
- Grade 2 sprain (moderate). The ligaments are partially torn. This type of injury may involve some loss of function.
- Grade 3 sprain (severe). The ligament is completely torn or the ligament is pulled off of its attachment to bone. These are significant injuries that require medical or surgical care. If the ligament tears away from the bone, it may take a small chip of bone with it. This is called an avulsion fracture.
Fractures. The wrist is composed of eight small bones that are fragile and can be easily fractured during a car accident. The most common wrist bone to be fractured is the radius, but one of the most commonly undiagnosed fracture is a fracture to the scaphoid bone.
Fractures of the scaphoid are often diagnosed late, and late diagnosis can result in a fracture that fails to heal (i.e., a non-union fracture). One medical article explains why scaphoid fractures are often diagnosed late:
Scaphoid fractures can escape early detection because in many cases they are subtle and the initial symptoms are minimal. Missed scaphoid fractures have a high risk of nonunion or malunion. Nonunion occurs in up to 12% of patients if an occult fracture is not detected and treated. Scaphoid nonunions are especially challenging to treat successfully, and if untreated, they can progress to carpal collapse and degenerative arthritis. Early diagnosis and appropriate treatment of an acute scaphoid fracture and the possible consequences of nonunion are critical to avoiding debilitating wrist problems.[1]
The fracture itself can disrupt blood flow to the area and contribute to the failure of the fracture to heal, i.e., non-union; thus, nonunion is more common with scaphoid fractures. A long standing non-union scaphoid fracture can lead to osteoarthritis or “scaphoid nonunion advanced collapse” (“SNAC”). Osteoarthritis is a painful disease process that can lead to decreased function and disability of the affected arm. Avascular necrosis, also known as bone death, is a common complication of a scaphoid fracture.
With long standing non-union or unhealed fractures, surgery may become necessary. Post-surgery, a patient may be required to wear a cast or splint for an average of 12 weeks up to 6 months or until the fracture is healed. During the post-surgery recovery period, a patient would usually be ordered to avoid the activities that may injure the wrist or prevent healing, such as lifting, carrying, pushing, or pulling more than one pound of weight. Post-surgery recovery may also require treatment with a trained hand therapist, as maintaining full finger motion is important.