Broken wrists are common work-related injuries. Although a "broken wrist" can indicate a number of different injuries, usually it refers to a fracture of the end of the radius bone at the wrist, or "distal radius fracture." Usually, distal radius fractures are a result of a fall on an outstretched hand.

In the past, orthopaedic surgeons treated most distal radius fractures with casts. Recently, this has been changing due to the results of an extensive study of the problem. Although these fractures usually do heal in a cast, they may not heal in the proper alignment. This may lead to problems over the long term, including arthritis and wrist instability. To prevent these problems, it is very important for the wrist to heal close to its original anatomic position, and often the surest way to ensure that this happens is with surgery. The surgery usually involves opening the wrist, putting the bones in the right position, and then holding them in that position with a plate and a number of screws. The plate and screws hold the bone until it heals. After the bone heals, they are no longer necessary. However, because it means additional surgery to take the plate out, it is usually left in place forever.

Distal radius fractures treated in the traditional manner are usually casted for six weeks, followed by therapy to restore range of motion. Surgically treated fractures are typically not casted, but are protected in a removable splint, which allows therapy to begin much earlier. This earlier motion, with less residual stiffness, is one of the advantages of operative treatment.

According to a 2007 study, average return-to-work time after a distal radius fracture was about nine weeks, although 20 percent of participants reported no lost work time (probably as a result of their specific occupation). The most important predictors of time lost were occupational demands and self-reported disability.

Another study from Canada looked at the level of disability six months after a distal radius fracture. Similar to what has been found in a number of workers' compensation studies related to orthopaedic injuries, patient factors rather than injury or treatment factors were found to be more predictive of disability. Injury compensation was the best predictor of pain and disability at six months. Patient education level and initial radial shortening (a measure of fracture severity) were also predictive. The majority of the patients in the study had very low disability levels at six months.

Although most distal radius fractures treated appropriately heal with few functional limitations, some degree of stiffness is common. Other potential complications include infection, carpal tunnel syndrome, and arthritis. As with any upper extremity injury, reflex sympathetic dystrophy is a feared, often devastating complication. It is fortunately rare, but can result in significant disability when it occurs, even in spite of appropriate treatment.

There is a spectrum of treatments and outcomes for distal radius fractures. It may require some time to accomplish healing, but most patients return to their previous occupations uneventfully.