Wrist Fractures - the “FOOSH” injury

The term “FOOSH” may be fun to say, but it certainly is not a fun experience to have.  FOOSH is a medical acronym for Fall On an Outstretched Hand.  When we slip and fall it is natural for our body to reflexively reach out the arm and hand (palm first) to break the fall.  Winter conditions involving icy parking lots and sidewalks result in a high incidence of FOOSH injuries this time of year. 

A FOOSH injury can involve a fracture to one of the small bones in the wrist, a fracture to a forearm bone, a dislocated elbow or shoulder, or a fracture to the collarbone or shoulder (humerus) bone.  By far the most common injury we see from a FOOSH injury is a “broken wrist” or Colles fracture.

The forearm consists of two long bones running side by side called the radius and the ulna.  A Colles fracture refers to a break of the radius at it’s distal end (closest to the wrist).  With FOOSH injuries we can also see fractures involving both the radius and the ulna.  These more complicated fractures often require a surgeon to put in a plate and screws to re-set them and allow for proper healing.  

The radius and the ulna are large bones with good blood supply and they typically heal very well.  A normal course of treatment would be to have the bone re-set if needed, and then to be immobilized in a cast for at least six weeks.

 When the cast is removed it is very normal to see a large loss of range of motion and strength in the wrist.  The skin often looks different and can be overly sensitive. Particularly as we get older and our bodies do not have as much natural flexibility, we will see more stiffness after the cast comes off.  This is the time that physiotherapy is important!  The wrist complex is quite a complicated joint and needs to move up and down, side to side as well as rotate into palm up/palm down motions.  The finger and hands also require a lot of complicated movements happening at once to give us full dexterity.  Strengthening the area is important as well. Unfortunately our bodies lose strength very quickly when they are immobilized.  Individuals are often surprised at how difficult a simple task like putting a plate away in a cupboard can be after getting their cast off. 

Proper rehab after a FOOSH injury can make a big difference in ensuring an individual gets their function back.  A physiotherapy treatment for this injury will often include:

-hands on treatment such as manual therapy and stretching to reduce joint stiffness

-strength exercises and dexterity exercises

-guidance in appropriate home exercises to be done on a daily basis

-education on tips to reduce pain and make daily tasks a bit easier when the wrist isn’t back to full use yet

If you have any additional questions regarding FOOSH injuries please contact our ARMP office to speak to a physiotherapist!