Colles Fracture

A Colles fracture is a break at the distal end (near the wrist) of the Radius (one of the two forearm bones, on the thumb side of the wrist).

Symptoms

Symptoms include instant pain in the wrist. The wrist may look deformed, known as a dinner fork deformity. Instant swelling will occur and the patient will have difficulty and pain trying to move the wrist. In very severe Colles fractures one end of the bone may pierce the skin which is known as an open fracture.

Colles fracture of the wristA colles fracture is a transverse fracture within 1 inch of the wrist joint, with (dorsal - upward) displacement of the fractured fragment.

The most frequent cause of a Colles wrist fracture is a fall onto an outstretched hand. This is especially common in older females who suffer (either knowingly or unknowingly) with Osteoporosis.

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

Plaster cast on wristInitial treatment should involve rest, protection and seeking medical attention immediately. An X-ray should be taken to determine the extent of the fracture and displacement of the fragment and an 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 comminuted.

The treatment of a Colles fracture depends on the extent of the damage. A straightforward fracture with no displacement will simply require casting to immobilise the bones until they are healed - usually around 6 weeks. A splint may be used for the first few days to allow 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.

Putty exercisesIn 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 fragment (s) 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 casted.

Once the cast is removed, physical therapy should be undertaken to regain full movement and strength in the wrist.