Workplace Fall Resulting in Wrist Injury - Assessment and Management

Case at a Glance

A 22-year-old female presents with acute wrist pain following a workplace fall onto concrete, with inability to move wrist independently and severe pain on passive movement.

Patient's Story

The patient, a 22-year-old female (5'4", 115 lbs) with no significant medical history, sustained a fall at her workplace approximately 30 minutes prior to presentation. She fell hard onto concrete flooring, instinctively extending her wrist to break the fall, also sustaining a knee abrasion. Initially, the wrist felt normal, but pain progressively worsened to the point of causing tears. The patient reports being unable to move her wrist voluntarily, with severe pain during passive range of motion testing. She had initiated basic first aid measures including ibuprofen, ice application, and elevation.

Initial Assessment

The patient presented with acute wrist trauma following a fall with outstretched hand mechanism. Physical examination revealed preserved finger mobility but significant limitation in wrist movement with severe pain on passive motion. The patient was uncertain about the need for imaging and expressed concerns about appropriate level of care and potential healthcare costs related to the workplace injury.

The Diagnostic Journey

Given the mechanism of injury (fall onto outstretched hand), progressive pain severity, and functional limitation of wrist movement, the clinical picture was highly suggestive of possible wrist fracture. The patient was advised to seek urgent medical evaluation for imaging studies. Initial hesitation was addressed through patient education about the appropriateness of emergency care for potential fractures and the importance of timely diagnosis.

Final Diagnosis

Suspected wrist fracture pending radiological confirmation (clinical diagnosis based on mechanism and presentation).

Treatment Plan

Immediate: Continue current symptomatic management with ice, elevation, and anti-inflammatory medication. Urgent medical evaluation recommended for X-ray imaging to rule out fracture. Patient advised to complete workplace injury documentation for workers' compensation coverage. Consideration for immobilization and pain management pending imaging results.

Outcome and Follow-up

Patient planned to seek medical evaluation the following morning due to rural location limitations and manageable pain level overnight. Workplace injury documentation to be completed for appropriate insurance coverage. Follow-up care to be determined based on imaging results and may include orthopedic consultation if fracture confirmed.