Colles Fracture of the Wrist

Colles Fracture - Wrist

A Colles fracture is a particular type of broken wrist involving a break of the radius or forearm bone on the thumb side of the wrist.

Symptoms

Symptoms include instant pain in the wrist with rapid swelling. The wrist may look deformed. This is known as a dinner fork deformity. The patient will have considerable pain when trying to move the wrist. In very severe wrist fractures one end of the bone may pierce the skin which is known as an open fracture.

To be diagnosed as a Colles fracture the break in the bone has to be a transverse fracture within 1 inch of the wrist joint, with fractured fragment of bone being displaced upwards.

The most frequent cause is a fall onto an outstretched hand. This is especially common in older females who suffer with Osteoporosis which is a weakening of the bones, occurring mainly in later life. Often the patient will not know they have weak bones.

Due to the force which is required to fracture the distal radius, sometimes a fracture of the end of the Ulna may also occur. Soft tissue injuries to the ligaments at the wrist especially are also common.

Treatment

If a wrist fracture is suspected then medical attention should be sought immediately. An X-ray should be taken to determine the extent of the fracture and displacement of the bone fragment. A full examination will help to rule out any other associated injuries. Sometimes the bone fragment may be broken into more than one piece. This is known as a comminuted fracture of the wrist.

The treatment of a Colles fracture depends on the extent of the injury. A straightforward fracture with no displacement will simply require casting to immobilise the bones until they are healed. This is usually around 6 weeks. A splint may be used for the first few days to allow the swelling to go down before the cast is applied.

Where there is minor displacement, a closed reduction may be performed, which is where the Doctor manipulates the arm until the bones align, before the cast is applied.

In more complicated cases where the bones are considerably displaced, or the fragment is in two or more pieces surgery may be required. The surgeon will realign the fragments and use pins or wires to hold them in place. The arm is then splinted for a few days to allow swelling to settle before being being put in a plaster cast.

Once the cast is removed, physical therapy should be undertaken to regain full movement and strength in the wrist. This will involve mobility exercises and exercises to strengthen the wrist such as using hand putty.

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