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Wrist fractures are common injuries in childhood. There are two bones in the forearm – the radius and the ulna. In a wrist fracture, one or both of these bones may be broken.
Sometimes the bones may need to be put back into position by a doctor or nurse practitioner in the emergency department or operating theatre, or your child may need surgery.
Your child will need a cast to support and protect the bones while the fracture heals. It is important to care for your child’s wrist and cast correctly after you leave hospital.
This fact sheet provides information on what to do once your child has been treated in hospital for a wrist fracture. If you think your child has a fracture and you are looking for first aid advice, see our fact sheet Fractures (broken bones).
Fractures are painful. Although immobilising the arm with a cast will help to reduce the pain, additional pain relief (e.g. paracetamol) is often needed. Give the pain relief medication regularly for the first few days, following the directions on the packet, or as directed by the doctor.
During the first two days and nights it is important for your child to rest and elevate their wrist above heart level to minimise swelling. From the third day, it is only necessary to elevate the wrist overnight.
Use an arm sling for the first week, making sure the fingers are above the level of the elbow.
Encourage your child to bend and straighten their fingers regularly, and make sure you check their fingers for movement, feeling and circulation.
Itching under the cast is common. Make sure your child avoids scratching inside the cast as this may damage the skin and cause infection. Do not let them push any object inside the cast (e.g. don’t allow them to use a ruler to scratch inside the cast). Never cut or attempt to modify
You can help relieve itch by using a hair-dryer to blow cold air into the cast (do not use warm or hot air as this can burn the skin or warp the cast). Antihistamines may be useful for reducing the itch. Talk to your local pharmacist about a suitable antihistamine medication to use.
If your child has a plaster cast, it is important to keep the cast clean and dry. For showering or bathing, seal the cast in a plastic bag with tape or a rubber band. Never allow your child to immerse the cast in water, even if it is in a plastic bag. For more information, see our fact sheet
Plaster cast care.
Even though fibreglass casts are waterproof, you need to make sure the padding underneath stays dry. If your child has a fibreglass cast, treat it as though it is a plaster cast and avoid getting it wet.
Severe pain and swelling, change in the colour of the fingers (white or blue), numbness or pins and needles, and inability to move the fingers are signs that the arm has not been elevated for long enough or that your child’s cast may be too tight. If any of these signs occur, rest and
elevate the arm above heart level for 30 minutes.
After elevating the arm for 30 minutes, take your child to the hospital emergency department immediately if:
Take your child to your GP or local hospital if:
Your child will usually need to have an X-ray and review five to seven days after they injure their wrist. The cast will not need to be removed for this X-ray. The doctor will tell you when your child should have their follow-up appointment.
The cast will be able to be removed once your child's fracture has healed.
When the cast is removed, the skin may be dry and itchy. Bathe with warm water and soap, and apply a gentle, non-perfumed moisturiser.
The wrist may be stiff when the cast first comes off, but children normally regain wrist movement and strength by using the arm for gentle activity and play. Physiotherapy is not often required.
Your doctor will give you specific advice regarding your child’s return to sport, which in most cases may be resumed four to six weeks after the cast is removed. If your child required surgery, full contact sports should be avoided for two to three months.
Take your child to the doctor if:
Will my child’s fractured wrist always be weaker than the
other wrist, even after it has healed?
Once the fractured bone has fully healed in the correct
position and alignment, then there is no residual weakness of the bone. It may
take some time for the muscles to regain their strength, if the arm has been
immobilised in a cast, but once this occurs, your child will return to their
normal strength and ability.
Do the follow-up appointments need to be at the hospital
where my child was originally treated?
– you can have your follow-up appointments at a local hospital or medical
centre that is equipped to manage fractures. Your doctor will be able to help
you find an appropriate place for a follow-up appointment.
Developed by The Royal Children's Hospital and the Victorian Paediatric Orthopaedic Network. We acknowledge the input of RCH consumers and carers.
Reviewed November 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
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