FOOSH Injuries: What Happens to Your Hands and Wrists When You Fall

Quick Answer

A FOOSH injury, Fall on Outstretched Hand, occurs when you instinctively reach out to break a fall. These injuries commonly include wrist fractures (including Colles’ fractures and scaphoid fractures), broken fingers, hand fractures, ligament tears, and nerve damage. Severity ranges from minor sprains to injuries requiring surgery and months of rehabilitation.

Key Takeaways

• FOOSH (Fall on Outstretched Hand) is the medical term for injuries sustained when you break a fall with your hands
• The most common FOOSH injuries are Colles’ fractures of the radius, scaphoid fractures, and wrist ligament tears
• Scaphoid fractures are particularly dangerous because they frequently do not appear on initial X-rays, causing delayed diagnosis and worse outcomes
• If your FOOSH injury occurred on someone else’s property due to a hazardous condition, California law may entitle you to compensation under premises liability principles
• California’s two-year statute of limitations under CCP Section 335.1 means prompt medical and legal attention is essential

What Is a FOOSH Injury?

When you start to fall, your body acts before your conscious mind does. Your arms extend, your palms face downward, and the full weight of your body loads onto your outstretched wrists and hands in a fraction of a second. This reflex protects your head and torso but concentrates enormous force into your upper extremities.

Medical professionals call this mechanism FOOSH, a Fall on Outstretched Hand. It is one of the most common injury mechanisms seen in emergency departments and orthopedic clinics. In the context of slip and fall accidents in California, FOOSH injuries are among the most frequently documented hand and upper extremity injuries, and they often generate significant medical costs, time off work, and lasting functional limitations.

Understanding exactly what happens to your wrist and hand during a FOOSH, and what your legal options are if someone else’s negligence caused your fall, is the focus of this article.

The Anatomy of a FOOSH: What Breaks and Why

The wrist is a complex joint involving the distal ends of the radius and ulna (the two bones of the forearm), eight small carpal bones, and a network of ligaments, tendons, and nerves. When a FOOSH occurs, the impact travels up from the palm through this entire structure.

The direction of the force, the angle of your wrist at impact, your age and bone density, the surface you landed on, and how fast you were moving all affect which structures take the most damage.

Colles’ Fracture

The Colles’ fracture is the most common fracture resulting from a FOOSH. It involves a break in the radius bone just above the wrist, causing the wrist to take on a characteristic “dinner fork” appearance due to the upward displacement of the bone fragment.

Colles’ fractures are extremely common in adults over 50 because reduced bone density means the radius is less able to absorb impact force. Younger adults can also sustain Colles’ fractures in high-energy falls.

Treatment typically involves splinting and casting for minor fractures, but more complex or displaced fractures require surgical intervention, often the placement of a metal plate and screws. Recovery spans six to twelve weeks in a cast, followed by physical therapy. Many patients experience some permanent reduction in grip strength or range of motion.

Scaphoid Fracture

The scaphoid is the small, boat-shaped bone at the base of the thumb on the thumb side of the wrist. It is the most commonly fractured carpal bone.

What makes scaphoid fractures particularly dangerous is that they frequently do not appear on initial X-rays. An injured person may leave the emergency room with a “normal” X-ray, assume they have a sprain, and delay treatment. This is a serious mistake. The scaphoid has a notoriously poor blood supply, and when a fracture goes untreated, the bone can develop avascular necrosis (bone death), leading to collapse of the wrist joint and permanent, severe arthritis.

A missed scaphoid fracture that leads to avascular necrosis and chronic wrist disability is a well-documented example of how an initial injury leads to long-term consequences, and how documented medical complications can significantly increase the value of a personal injury claim.

If you are seen after a FOOSH and told you have a “wrist sprain,” ask your doctor specifically about scaphoid fracture and whether a follow-up MRI or CT scan is recommended. These imaging modalities detect scaphoid fractures that X-rays miss.

Smith’s Fracture

Less common than the Colles’ fracture, a Smith’s fracture (sometimes called a reverse Colles’) involves a break in the radius with the bone fragment displaced in the opposite direction, toward the palm. This typically occurs when you land with your wrist flexed downward rather than hyperextended.

Distal Radius Fracture (General)

“Distal radius fracture” is the broader category that includes Colles’ and Smith’s fractures as well as other break patterns at the lower end of the radius. It is the most frequently occurring fracture in the human body, accounting for approximately one in six of all fractures treated in emergency settings.

Scapholunate Ligament Tear

When the force of impact is absorbed by the wrist’s ligament network rather than the bones, the scapholunate ligament, connecting the scaphoid and lunate carpal bones, can tear partially or completely. This injury is often misdiagnosed as a wrist sprain.

An untreated scapholunate ligament tear leads to progressive wrist instability and eventually a collapse pattern called SLAC wrist (Scapholunate Advanced Collapse), which produces chronic pain and significant loss of function. Surgical repair is typically required for complete tears.

Hand and Finger Fractures

FOOSH impacts can also fracture the metacarpal bones of the hand (the long bones running from the wrist to the fingers) and the phalanges (finger bones). A broken finger may seem minor compared to a wrist fracture, but fractures involving the finger joints, or fractures that heal in a maligned position, can permanently affect grip strength, dexterity, and fine motor control.

For anyone whose occupation requires manual dexterity, a surgeon, a musician, a construction worker, a mechanic, even a “minor” hand fracture may carry significant occupational consequences.

Other Injuries Associated with FOOSH Falls

Triangular Fibrocartilage Complex (TFCC) Tears

The TFCC is a cartilage structure on the little-finger side of the wrist that stabilizes the joint. FOOSH injuries can tear this structure, producing pain on the outer wrist, weakness, and clicking with rotation. TFCC tears are often missed on standard X-rays and may require MRI for diagnosis.

Nerve Damage

Median nerve injury (which can present similarly to carpal tunnel syndrome) and injury to the ulnar nerve can result from wrist fractures and the swelling that follows them. In some cases, acute carpal tunnel syndrome develops when post-fracture swelling compresses the median nerve, requiring emergency surgical decompression.

Elbow Injuries

In some FOOSH incidents, particularly high-energy falls, the impact force travels up the forearm and fractures the radial head at the elbow, or damages the elbow ligaments.

Shoulder Injuries

The force of a FOOSH can transmit further up the limb, particularly in younger individuals with strong wrist and forearm bones. Shoulder fractures (including proximal humerus fractures) and rotator cuff tears can result when the energy travels past the wrist and forearm.

When a FOOSH Happens Because of Someone Else’s Negligence

Many FOOSH injuries occur during slip and fall accidents on commercial or residential properties. A wet floor without a warning sign, a cracked sidewalk, a loose mat, an uneven parking lot, these conditions cause falls that cause FOOSH injuries every day throughout California.

Under California Civil Code Section 1714, property owners owe a duty of ordinary care to people on their premises. When a property owner fails to maintain safe conditions and that failure causes your fall and your FOOSH injuries, California law allows you to seek compensation for your losses.

What You Can Recover

Compensable damages following a FOOSH injury sustained in a California slip and fall can include:

• Medical expenses: Emergency care, imaging, orthopedic surgeon fees, physical and occupational therapy, assistive devices, future treatment for chronic conditions like SLAC wrist or post-traumatic arthritis
• Lost wages: Time missed from work during recovery, particularly significant if your job involves manual tasks
• Lost future earning capacity: If your injuries leave you unable to perform your prior occupation
• Pain and suffering: Physical pain, disrupted sleep, difficulty with daily activities
• Emotional distress: Anxiety, depression, and reduced quality of life following a serious injury

The Importance of Documenting Your FOOSH Injury

One challenge in FOOSH injury claims is that insurance adjusters often characterize wrist and hand fractures as “minor” injuries. They are not minor when you factor in the full picture: surgical costs, weeks in a cast, months of physical therapy, potential for permanent impairment, and the functional demands of the injured person’s work and daily life.

Thorough medical documentation is essential. This means:

• Seeking emergency or urgent care immediately after your fall, even if you think you “just sprained” something
• Following up with an orthopedic specialist, not just the ER
• Requesting appropriate imaging (MRI or CT if your doctor suspects scaphoid involvement)
• Following all treatment recommendations and attending all follow-up appointments
• Keeping detailed records of how the injury affects your daily life and work

FOOSH Injuries at Work: California Workers’ Compensation

If your FOOSH injury occurred at your workplace, whether you slipped in a warehouse, on a restaurant floor, or in an office building, California workers’ compensation laws apply. Workers’ compensation provides benefits for medical treatment and temporary disability regardless of fault.

In some workplace fall cases, a third party (such as a contractor who created a hazardous condition, or a property owner who is not your direct employer) may also bear civil liability. An experienced attorney can evaluate whether a third-party claim supplements a workers’ compensation claim.

Example Scenarios

Scenario 1: Wet Produce Aisle

A 52-year-old teacher in Riverside walks through a grocery store’s produce section and slips on water that had accumulated near a misting display. She extends her arms to catch herself and sustains a Colles’ fracture requiring surgical fixation with a plate. She is unable to write or type for 10 weeks during the school year. Her attorney documents the absence of wet floor signs, the grocery store’s maintenance records, and her specific occupational losses. The case resolves through mediation.

Scenario 2: Missed Scaphoid Fracture

A 28-year-old graphic designer trips over a raised threshold at the entrance to a restaurant in Costa Mesa, extending his hand to catch himself. The emergency room X-ray shows no fracture. He is told it is a sprain and discharged. Six weeks later, ongoing pain sends him to an orthopedic specialist, who orders an MRI revealing a scaphoid fracture with early avascular necrosis. He requires surgery and occupational therapy. The delayed diagnosis resulted from inadequate initial imaging, and the injury claims both the restaurant’s liability and an exacerbated injury.

Scenario 3: Apartment Complex Stairway

A tenant in an Orange County apartment complex slips on a wet outdoor staircase after a rainstorm. She falls forward, extends both hands, and sustains bilateral wrist sprains with a confirmed TFCC tear in her dominant wrist. She undergoes six months of occupational therapy and has ongoing limitations with typing and lifting. An attorney evaluates the landlord’s obligation to maintain safe common areas and the tenant’s right to compensation beyond workers’ compensation.

California Laws and Your Rights

• California Civil Code Section 1714: Every person is responsible for injury to others caused by their failure to exercise ordinary care. This applies to all California property owners.
• California Code of Civil Procedure Section 335.1: You have two years from the date of your injury to file a personal injury lawsuit. Do not let time pass before consulting an attorney.
• Premises liability standard: In California, property owners must inspect their property for hazards, repair known hazards promptly, and warn invitees of conditions they knew about or should have discovered through reasonable inspection.
• Workers’ compensation: Workplace fall injuries are covered under California Labor Code Sections 3200 et seq. regardless of fault. Third-party civil claims may also be available.

How an Attorney Can Help

FOOSH injuries are among the most undervalued claims in slip and fall litigation. Insurance adjusters routinely downplay wrist and hand fractures as minor, failing to account for the true cost of surgery, extended rehabilitation, and the permanent limitations that commonly follow.

The Accident Network Law Group, led by Attorney Damoun A. Yazdi, handles FOOSH and slip and fall injury claims throughout Southern California. Attorney Yazdi’s experience as a former Los Angeles County DA’s Office Law Clerk and 12 years in personal injury law means he understands how to build a case that reflects the full value of your injuries.

There are no upfront legal fees. The firm works on a contingency basis, meaning you pay nothing unless compensation is recovered on your behalf. Consultations are available 24 hours a day, 7 days a week, and the firm is bilingual (se habla español).

To discuss your FOOSH injury and whether you have a premises liability claim, contact The Accident Network Law Group for a free consultation.