The Wrist Fracture That Should Change Your Next Doctor’s Visit
Form & Function MD · Dr. Ben, MD
A fall from standing height. An outstretched hand. A broken wrist. I treat this fracture constantly, and most heal well. But in someone over 50, I want them to leave with more than a cast: I want them to understand what the fracture may be telling us about their bones.
A fragility fracture is a signal
A fracture from a fall at standing height or less is called a fragility fracture. Healthy bone usually withstands that kind of fall, so a break suggests the bone may be weaker than it should be.
The wrist (distal radius) is often the first fragility fracture a person has. It tends to occur at a younger age than hip fractures, because when we're younger and quicker, we put a hand out when we fall. That makes the wrist fracture an early warning, sometimes years before a more serious hip or spine fracture.
The risk of the next fracture
A prior fracture is one of the strongest predictors of future fractures. A large synthesis of the literature found that a previous fracture roughly doubles the risk of a subsequent one. Yet many patients with a wrist fracture are never evaluated for osteoporosis afterward. The cast comes off, the wrist works again, and the underlying problem goes unaddressed.
- A DEXA scan to measure bone density, if you haven't had a recent one
- A fracture risk assessment that combines bone density with your age, history, and other risk factors
- Whether medication makes sense — several classes of medications reduce fracture risk in people with osteoporosis
- A fall-risk and balance evaluation — preventing the next fall matters as much as strengthening the bone
- Basic labs your physician may want to check, depending on your history
The fall is half the equation
A fracture needs two things: bone that can break and a force that breaks it. Most wrist fractures come from falls, so balance and strength matter as much as bone density. Balance is trainable at any age, and structured exercise programs reduce falls in older adults at increased risk.
Building bone after a fracture
Bone responds to load. Once the fracture has healed and your surgeon clears you, a progressive resistance training program is one of the most useful things you can do. In the LIFTMOR trial, postmenopausal women with low bone mass who did supervised, high-intensity resistance and impact training improved bone density at the spine and hip, without an increase in injuries.
That doesn't mean jumping straight into heavy lifting. It means starting with good technique, building load progressively, ideally with guidance, and making it a long-term habit rather than a short program.
- Strength training two to three days a week, including lower body and back
- Daily balance practice: single-leg stands, heel-to-toe walking
- Adequate protein and calcium from food, and vitamin D if you're deficient
- A home safety check: lighting, rugs, stairs, and bathroom footing
- Follow-up on your bone density results, not just your X-rays
This article is for education, not a diagnosis. If something here sounds like you, see a physician who can examine you.
- Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–739.
- Watson SL, et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. J Bone Miner Res. 2018;33(2):211–220.
- U.S. Preventive Services Task Force. Falls prevention in community-dwelling older adults: interventions. 2024.