Wrist Fracture Prevention: 13 Evidence-Based Strategies

Primary Prevention (Reduce Fall & Impact Risk)

1. Wrist guards for high-risk activities: skateboarding, snowboarding, rollerblading, hoverboard, contact sports. Rigid dorsal stay limits hyperextension.
2. Fall prevention: Home safety (grab bars, non-slip mats, lighting, declutter), vision checks, medication review (sedatives, antihypertensives), balance training (Tai Chi, Otago).
3. Ice/weather caution: Microspikes, penguin walk, handrails, avoid rush.
4. Safe falling technique: Tuck chin, roll onto shoulder/back, avoid FOOSH (fall on outstretched hand). Practice in martial arts/gymnastics.

Secondary Prevention (Strengthen Bone & Tissue)

5. Weight-bearing + resistance exercise: 150 min/week moderate + 2× resistance. Wrist-specific: wrist curls, grip squeezes, farmer's carries, planks.
6. Bone health: Calcium 1000–1200 mg/day (diet > supplements), Vitamin D 1000–2000 IU (target 25-OH-D >30 ng/mL), protein 1.2 g/kg.
7. Osteoporosis screening: DXA at 65 (women), 70 (men) or earlier if risk factors (FRAX). Treat if T-score ≤−2.5 or FRAX high.
8. Medication review: Minimize glucocorticoids, PPIs, SSRIs, anticonvulsants if possible.

Tertiary Prevention (Ergonomics & Early Intervention)

9. Ergonomic workstation: Neutral wrist (0–15° extension), split keyboard, vertical mouse, monitor at eye level, forearm support.
10. Microbreaks: 30 sec every 20 min (stretch, shake out); 5 min every hour.
11. Assistive devices: Cart for heavy loads, jar openers, lever handles, voice dictation.
12. Manage comorbidities: Diabetes (glycemic control → collagen quality), RA (DMARD control), thyroid.
13. Early eval for persistent pain: >2 weeks → clinician; imaging if trauma or mechanical symptoms.

Special Populations

• Children: Playground surfaces, trampoline nets, wrist guards for skating.
• Postmenopausal women: Highest distal radius fracture risk; prioritize bone health + fall prevention.
• Vitamin D deficiency: Universal supplementation in winter (latitude >35°).

Quick Reference: Fall Mechanics → Fracture Pattern

Fall Type	Typical Fracture
FOOSH (hand out, wrist extended)	Distal radius (Colles' – dorsal angulation)
FOOSH (wrist flexed)	Distal radius (Smith's – volar angulation)
Direct blow (dorsal wrist)	Scaphoid, triquetrum, distal radius
Axial load (fist punch)	Scaphoid, capitate, carpometacarpal

Most wrist fractures are preventable. Invest in bone health, fall-proofing, and ergonomics early.