Wrist Pain After a Fall? It Could Be Something Rare

Most wrist injuries after a fall are straightforward—often a sprain or a common fracture. But in some cases, there may be an underlying condition that makes the injury more complex.

A recent study featuring Dr. David Kirschenbaum highlights a rare condition called a carpal coalition and how it can increase the risk of certain wrist fractures.

A carpal coalition occurs when two or more of the small bones in the wrist are joined together instead of being separate. This can happen during development and is often something a person is born with.

Most people with this condition don’t even know they have it because it usually doesn’t cause symptoms.

Although many carpal coalitions are harmless, they can sometimes:

• Change how the wrist moves
• Place extra stress on nearby bones
• Increase the risk of fractures after an injury

The study explains that these changes in wrist mechanics can make certain bones more vulnerable—even with relatively minor trauma like a simple fall.

In this case, a 62-year-old woman experienced wrist pain after a fall. Initial X-rays did not show a fracture, but a closer look (as seen in the imaging on page 2) revealed an unusual connection between three wrist bones.

An MRI later confirmed:

• A rare incomplete coalition of three wrist bones (capitate, trapezoid, and trapezium)
• A small fracture of the trapezoid bone that wasn’t visible on initial X-rays

This combination had not been previously reported, making it a particularly unique case.

This study highlights an important point for patients:

Not all fractures show up right away on X-rays.

If pain continues or worsens after an injury, additional imaging—such as an MRI—may be needed to detect hidden injuries or underlying conditions.

Fortunately, this patient did not need surgery. She was treated with:

• A wrist splint
• Rest and protection of the joint

Over time, her pain improved, and she made a full recovery within a few months, regaining normal motion and function.

If you have wrist pain after an injury, especially if:

• X-rays are normal
• Pain isn’t improving
• You have lingering swelling or limited motion

…it’s important to follow up with a specialist.

Rare conditions like carpal coalitions can make injuries harder to detect, but with proper evaluation and treatment, outcomes are often very good.

Dr. Kirschenbaum contributed to this study to bring attention to rare wrist conditions that can impact diagnosis and treatment. Research like this helps physicians recognize unusual patterns and improve patient care.

To learn more, read the full published study:
Unilateral Incomplete Coalition of the Capitate, Trapezoid, and Trapezium with Trapezoid Fracture