What is a dislocated wrist and how do you treat it?

Published: November 2024

Wrist joints contain eight small bones, called carpals. Within the wrist, there are also ligaments that hold the wrist into place and allow flexible movement. A dislocated wrist can occur when any of these ligaments tear, which then causes your carpal bones to be displaced out of their usual position.

Dislocated wrist injuries typically involve the capitate and lunate bones, which are located in the hand and wrist. Situated in the lower palm, the capitate is the largest bone in the hand. The lunate is located in between the capitate and ulna, which is the long bone found in the forearm.

There are four different types of wrist dislocations that may occur. These include:

• Perilunate dislocation: This type of wrist dislocation involves the lunate bone and the three ligaments surrounding it. These three ligaments are the radioscaphocapitate, the scapholunate interosseous and the lunotriquetral interosseous. When these ligaments are damaged, it results in the perilunate bone rotating. Often, this type of wrist dislocation occurs after a fall onto an outstretched hand or from a car crash. It can often be missed on initial imaging tests.
• Galeazzi fracture: A break in the radius bone which then causes a dislocation of the distal radioulnar joint is called a Galeazzi fracture. Typically, this type of dislocation of the wrist occurs in both young men with high-energy trauma such as sports or vehicle accidents, and older women with low-energy trauma like falls from ground-level surface.
• Monteggia fracture: This occurs when there is a break in the ulna, which leads to a dislocation at one of the ends of the radius. Similarly to the Galeazzi and perilunate conditions, this often occurs after a fall onto an outstretched hand. Monteggia fractures are most common in children ages 4 to 10. 
• Anterior lunate dislocation: This type of dislocation of the wrist occurs when the lunate bone rotates, while the other bones in the wrist stay in place. This type is not as common and primarily occurs in young adults playing high-impact sports.

As with any dislocation, a dislocation of the wrist is accompanied by intense pain that is worse when you try to rotate your wrist, move it up and down or side to side. Pain may also be felt in the forearm. 

Here’s how you can identify a dislocation of the wrist joint: 

• Discolouration or bruising around the wrist 
• Tenderness 
• Swelling 
• Weakness
• Extreme pain 
• Redness 
• Inability to flex the wrist or use the joint

An orthopaedic specialist will be able to identify and diagnose what type of injury your wrist has sustained by a physical examination. Following this examination, the orthopaedic specialist can then provide the necessary treatment and next steps. However, further tests such as MRI and X-rays may be used to confirm the condition.  
 
Here are some key differences between a dislocated wrist, fractures and sprains: 

• Fractures: This type of injury can often have the same causes as a dislocation. However, a fracture often only occurs when one or more of the carpals are broken in the wrist. As such, the bone may break into two or more pieces. 
• Dislocated bones: This can occur when ligaments are damaged. Wrist dislocations can occur from fractures in the wrist; however, it does not damage the wrist bones themselves. 
• Sprains: Sprains can be present when the ligaments within the hands are torn or broken. However, this does not often result in a dislocation, meaning a sprained wrist is the least severe wrist injury to sustain.

A dislocated wrist can cause damage to bones, ligaments, tendons and nerves.

It can be difficult to determine whether your wrist is dislocated or broken, however, an orthopaedic specialist can usually tell by examining the wrist and checking for any obvious deformities. The symptoms can be similar, as both conditions will be presented with extreme pain. If there are no obvious deformities within the wrist joint, an X-ray or MRI scan will be able to confirm the injury. 

If you have a dislocated wrist, you will not be able to move it freely without extreme pain. The wrist will look dislodged, and deformed, while the hand will appear swollen after dislocation. Stiffness may also be present in the wrist. 

A dislocation of the wrist can occur from any kind of traumatic injury. Common causes include: 

• Car accidents 
• Breaking a fall on your hand or landing on one of your outstretched hands 
• High-impact sports such as football, hockey, rugby and tennis

Constant strain on your wrists can also result in a dislocated wrist, such as putting pressure on the wrists from walking with crutches. 

As it’s a serious injury that requires medical attention, you should always visit A&E if you suspect you have a dislocation in the wrist. An orthopaedic specialist will determine the severity of the injury through an X-ray or MRI test.  

Some potential initial treatment options include: 

• Rest, ice, compression and elevation (RICE) to manage and aid the injury.
• Anti-inflammatory medication such as ibuprofen for pain relief. 

A protective wrist support or sling to immobilise the wrist during recovery. Learn how to wear a wrist support here. 

• A cast to stabilise the wrist while it heals.
• Surgery if the injury is severe, traumatic and not responsive to other conservative treatments. 

The Elastoplast Protective Wrist Support is tested by physiotherapists and sports doctors, providing protection from further injury and relief to the wrist. This can be used after the necessary treatment of a dislocated wrist. 

The Elastoplast Performance Wrist Support supports active recovery to the wrist after injury, while providing a moderate level of protection during sports and other physical activity.

A dislocated wrist can take some time to heal, depending on the severity of the injury. For instance, if surgery is needed to correct the dislocation, it could take six months to a year for your wrist to recover fully.  

Post-treatment, you will need to follow up with physical therapy to rebuild strength and flexibility in the wrist. A physiotherapist specialising in wrist injuries can recommend some gentle exercises you can perform in your own time to aid recovery. 

Technically, a dislocation of the wrist can heal itself over time, but this will largely depend on the severity of the dislocation. It's also not recommended to rely on your wrist to heal on its own without proper diagnosis and treatment.

Following treatment, your wrist may present new symptoms as it heals. You should always seek immediate medical attention if you suspect any of the following symptoms: 

• Your cast or splint is causing you problems 
• You have a fever 
• You are experiencing severe or increasing pain 
• You are unable to move your fingers 
• You are experiencing tingling, numbness or weakness in your hand and fingers 
• You notice your fingers have turned cold, pale or have changed colour 

A dislocation of the wrist can have a significant impact on an individual's daily life. Therefore, it's vital that if you suspect you have a dislocated wrist, you seek immediate medical attention. A medical professional can determine the severity of the injury and provide prompt treatment if necessary.