Wrist Hairline Fractures

By Samantha Brown, ATC, LAC

Overview of Wrist Hairline Fractures

The anatomy of the human hand and wrist

Anatomy of the human hand and wrist.

A hairline fracture, sometimes known as a stress fracture, is a small crack in the bone. Hairline fractures are most common in weight-bearing extremities such as the feet and ankles. However, they may also be found in the wrist, particularly in individuals that participate in a lot of overhead activities. Any bone that absorbs a lot of stress during activity is at risk for a hairline fracture.

The wrist is made up of eight small bones, called the carpal bones, which connect with the two long forearm bones called the radius and ulna. Although a hairline fracture can happen in any of these bones, by far the most commonly affected bone is the radius. Anyone who engages in regular, repetitive physical activity can develop a hairline fracture.  Dr. Garry Kitay states “The majority of wrist fractures heal with immobilization and conservative treatment. However, certain fracture types benefit from a surgical approach. Using modern fixation techniques, and early rehabilitation, excellent outcomes are generally achieved.”  Dr. Kitay is a board certified orthopedic hand specialist at the JOI San Marco Clinic.

 

Causes of Hairline Fractures

Hairline fractures may occur as a result of a couple of different factors:

  1. Overuse or repetitive activities.
    1. Bones are rigid in maintaining their structure. However, they also have a degree of elasticity that allows them to react to specific movements, allowing them to slightly bend in order to absorb the impact of certain activities. However, when the same kind of strain is placed on a bone repetitively, a hairline fracture may develop.
  2. Change in type of activity.
    1. Regardless of the type of shape you are in, if you decide to suddenly switch the type of activity you do, it may place you at a higher risk for hairline fractures. This is due to the change in stress that you are placing on your bones.

Risk Factors for Hairline Fractures

There are also a certain number of risk factors that may increase your chances of getting a hairline fracture:

  • High impact sports: Higher impacts result in more stress places on the bones.
  • Weakened bones: Conditions such as osteoporosis leave bones in a weakened state, increasing the risk of injury.
  • Malnutrition: Lack of vitamin D or calcium can make bones more susceptible to injury.
  • Gender: Women, especially those with absent menstrual periods, are at an increased risk for hairline fractures.
  • Previous hairline fractures: Having one hairline fracture leaves an individual at a higher risk of having another.

 

Signs & Symptoms

Pain and other symptoms caused by hairline fractures are intensified when performing an activity that puts stress on the injured bone. It is important to note that pain from a hairline fracture will often present as an ache with some sharp pain during activity. This is different from a more severe fracture that will cause a significant amount of sharp pain immediately.

Other symptoms of a hairline fracture include:

  • Limited mobility
  • Swelling
  • Bruising
  • Point tenderness

Diagnosis

If you believe that you may have a hairline fracture, it is important to see a doctor as soon as possible. If hairline fractures are left undiagnosed or untreated, they could cause further complications. The first step to a diagnosis is a physical exam by a physician. However, imaging may be necessary to confirm the diagnosis. These tests may include:

  • X-ray
  • Magnetic resonance imaging (MRI)
  • Bone scan

Hairline fractures may not always be visible on an x-ray. The best imaging test for diagnosing a hairline fracture is an MRI.

Management

Management for a hairline fracture can be done both at home and through medical treatment. Home treatments can include:

  • The RICE method: Rest, Ice, Compression, Elevation.
  • Anti-inflammatory drugs (NSAIDs).
  • Non-weight bearing activities to stimulate the healing process.
    • Swimming, cycling, or running in a pool may help.

Further treatment may be necessary if the pain becomes severe or does not get better with rest. A doctor may recommend:

  • Splinting to reduce strain on the affected bone or group of bones.
  • Surgery if the injury is not healing on its own.

Complete recovery from a hairline fracture usually takes between 6 to 8 weeks.

 

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