Broken Wrist Settlement Value: Distal Radius, Scaphoid, and the Functional Outcome

Wrist fractures are common in California injury cases and produce a wide valuation range because outcomes are highly variable. The same mechanism — fall onto outstretched arm — can produce a clean non-displaced distal radius fracture that heals perfectly and a comminuted intra-articular distal radius fracture that produces lifelong stiffness. Both are “broken wrist” cases on the case summary, but they settle very differently. This page covers the anatomical variations, the treatment branches, and the outcome categories that drive valuation.

Anatomy of wrist fracture

The wrist comprises eight carpal bones plus the distal ends of the radius and ulna. The most common fracture patterns in trauma cases:

• Distal radius fracture — the radius bone at the wrist. Subdivided into:
  • Extra-articular fractures — break does not extend into the wrist joint surface.
  • Intra-articular fractures — break extends into the joint surface, producing higher arthritis risk and worse long-term outcomes.
  • Colles fracture — classic distal radius fracture with dorsal angulation, from fall on dorsiflexed hand.
  • Smith fracture — distal radius fracture with volar angulation, from fall on flexed hand.
• Distal ulnar fracture — often accompanies distal radius fracture, may or may not require separate treatment.
• Scaphoid fracture — the boat-shaped carpal bone in the thumb-side of the wrist. The most commonly fractured carpal bone, with notoriously difficult healing due to its tenuous blood supply.
• Other carpal fractures — lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate. Less common, but can produce significant dysfunction.

The wrist joint’s complexity — small bones, joint surfaces, tendons crossing in tight spaces — means that injury patterns affecting the joint surface or producing alignment problems carry significantly worse long-term outlooks than extra-articular fractures with clean reduction.

Severity tiers

Wrist fracture outcomes determine valuation tier:

Non-displaced or minimally displaced fracture, good healing. Cast treatment, full healing, return to baseline function. Settlement value range: $12,000–$25,000.

Displaced fracture, closed reduction or ORIF, good outcome. Surgical or near-surgical treatment, healing in good alignment, full or near-full functional recovery. Settlement value range: $25,000–$50,000.

Intra-articular fracture with surgical fixation. Joint surface involvement, ORIF with anatomic restoration of the articular surface, monitoring for post-traumatic arthritis. Settlement value range: $40,000–$80,000.

Fracture with residual stiffness or weakness. Loss of range of motion, decreased grip strength, ongoing pain. Settlement value range: $50,000–$100,000.

Scaphoid nonunion or SNAC wrist progression. Failed healing of scaphoid fracture, predictable progression to wrist arthritis, eventual need for salvage procedures (proximal row carpectomy, four-corner fusion, wrist arthrodesis). Settlement value range: $75,000–$200,000+.

Complex regional pain syndrome (CRPS). A small percentage of wrist fracture cases develop CRPS — a chronic pain disorder with disproportionate pain, color changes, temperature changes, and functional limitation. CRPS substantially raises case value. Settlement value range: $100,000–$500,000+.

What moves the dollar number

The factors that drive wrist fracture valuation:

Fracture pattern. Intra-articular fractures produce worse outcomes than extra-articular fractures because joint surface incongruity leads to post-traumatic arthritis. The imaging report’s characterization of the fracture pattern is critical evidence. CT scans (more detailed than X-ray for fracture pattern) often clarify the case.

Quality of reduction. Whether the fracture heals in anatomic position (or as close as possible) determines long-term outcome. Treating surgeon’s documentation of the reduction quality, post-reduction imaging, and post-healing imaging all matter.

Range of motion at maximum medical improvement. Treating physician’s measurements of wrist flexion, extension, pronation, supination, and ulnar/radial deviation — compared to the unaffected wrist — quantify residual impairment. Loss of 20%+ ROM is meaningful damage.

Grip strength. Measured by dynamometer, compared to unaffected side. Loss of grip strength is a quantifiable functional impairment that supports damages.

Occupation. Manual laborers, surgeons, musicians, dental professionals, and others with hand-intensive occupations face higher impact. Vocational expert testimony on lost earning capacity in younger working plaintiffs can add substantial value.

Hardware-related symptoms. ORIF cases may produce hardware pain or skin irritation requiring removal surgery — a recoverable future medical expense.

Multiplier framework

Wrist fracture cases typically apply a 2× to 3.5× multiplier for non-economic damages, with the multiplier moving toward the upper end based on severity, surgical intervention, and residual impairment.

Non-surgical, full recovery: $7,000 economic × 2 = $14,000 non-economic, gross $21,000. Surgical with hardware, good outcome: $25,000 economic × 2.5 = $62,500 non-economic, gross $87,500. Surgical with residual stiffness: $30,000 economic × 3.5 = $105,000 non-economic, gross $135,000.

Cases with CRPS or scaphoid nonunion progressing to SNAC wrist push into the 3.5× to 5× range and require substantial damages development including:

• Treating physician opinion on permanence;
• Vocational expert testimony on work impact;
• Life-care plan for future treatment and possible revision surgery;
• Pain management treatment records.

What the defense argues

Wrist fracture defense patterns:

Fracture healing as evidence of full recovery. The defense argues that fractures heal and that residual symptoms are exaggerated or unrelated. The plaintiff’s counter requires range-of-motion measurements, grip strength testing, and treating physician opinion on permanence.

Pre-existing arthritis attribution. Imaging often shows some degenerative wrist findings unrelated to the acute fracture. The defense attributes residual symptoms to pre-existing arthritis. The aggravation framework applies — the plaintiff recovers for the aggravation caused by the fracture.

Hardware removal as elective. Future hardware removal is sometimes characterized as elective. Treating surgeon opinion that removal is reasonably anticipated due to hardware-related symptoms supports the future medical claim.

Therapy over-utilization. Extended PT or occupational therapy is characterized as excessive. The plaintiff’s counter relies on treating physician orders and the actual functional progression documented in the therapy records.

Scaphoid nonunion as treatment failure rather than injury sequela. Defense argues that nonunion represents a treatment-side problem rather than a direct injury sequela. The defense distinction rarely succeeds — California’s eggshell-plaintiff rule and aggravation framework support recovery for the full sequela of the injury regardless of treatment outcome.

Related upper-extremity injuries

Versus Broken Arm. Humeral, radial shaft, or ulnar shaft fractures involve different anatomy with different healing patterns. Cases with both wrist and arm fractures are valued additively.

Versus Broken Collarbone. Sometimes co-occur in falls onto outstretched arm. Additive valuation.

Versus Rotator Cuff Tear. Shoulder injury can accompany wrist injury when the fall mechanism torques the entire upper extremity. Separate evaluation and additive valuation.

The wrist fracture case’s value depends on the specific anatomy involved, the quality of the reduction, and the residual functional outcome. Routine fracture-and-heal cases sit in the moderate tier; complication-prone cases (intra-articular fractures, scaphoid nonunion, CRPS) move substantially higher with appropriate evidence development.