Colles' Fracture

 

What is a Colles’ Fracture?

A Colles' fracture -- or distal radius fracture -- is often called a ''broken wrist.''  In France it’s sometimes called a “Pouteau-Colles” fracture. Technically, it's a break in the larger of the two bones in your forearm. The bone breaks on the lower end, close to where it connects to the bones of the hand on the thumb side of the wrist.

Colles' fractures are very common; they're the most frequently broken bone in the arm. In the United States, 1 of every 10 broken bones is a broken wrist.

Colles’ Fracture Symptoms

Symptoms of a broken wrist can include:

  • Pain, especially when flexing the wrist
  • Tenderness
  • Swelling
  • Bruising
  • Deformity of the wrist, sometimes called a “dinner fork deformity,” which causes it to look crooked and bent.

To diagnose a broken wrist, your doctor will give you a thorough physical exam. You may need several sets of X-rays, since the fracture may be hard to see at first.

Occasionally, a broken wrist can affect the nerves or blood flow. You should go to the emergency room if:

  • Your wrist is in great pain.
  • Your wrist, arm, or hand is numb.
  • Your fingers are pale.

Colles’ Fracture Causes

Usually, these injuries result from falling onto an outstretched arm or getting hit on the wrist.

Broken wrists are common in people who play contact sports, as well as skiers, inline skaters, and bikers. People with osteoporosis or thinning of the bones are at particularly high-risk for wrist fractures. But they can happen to anyone who takes a fall or gets hit.

Colles’ Fracture Treatment

If the broken wrist isn’t in the correct position to heal, your doctor may need to reset it. This can be pretty painful so it's usually done with anesthesia. However, painkillers will help afterward.

You will probably also need:

  • A splint, which you might use for a few days to a week while the swelling goes down; if a splint is used initially, a cast is usually put on about a week later.
  • A cast, which you might need for 6 to 8 weeks or longer, depending on how bad the break is (you might need a second cast if the first one gets too loose after the swelling goes away.)
  • Regular X-rays to make sure your wrist is healing normally

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Recovery

You will probably also want to:

  • Elevate your wrist on a pillow or the back of a chair above the level of your heart for the first few days. This will ease pain and swelling.
  • Ice the wrist. Do this for 15 to 20 minutes every 2 to 3 hours for 2 to 3 days. Be careful to keep the splint or cast dry while icing.
  • Take over-the-counter painkillers. Ask your doctor about nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or aspirin (except for children). They can help with pain and swelling. However, these drugs have side effects, such as an increased risk of bleeding and ulcers. They should be used only occasionally unless your doctor specifically says otherwise, as this may delay healing.
  • Practice stretching and strengthening exercises of the fingers, elbow, and shoulder if your doctor recommends them.

Most of the time, these treatments will be enough. But sometimes, people with a broken wrist need surgery. Your doctor might suggest this if the bone is not likely to heal well in a cast. Sometimes, pins, plates, screws, or other devices are needed to hold the bone in place so it can mend.

Colles’ Fracture Outlook

Of course, what you really want to know is when you can get back in the game after breaking your wrist. There's no easy answer.

Here are some things to keep in mind during recovery from a broken wrist:

  • It might take 8 weeks or longer for your wrist to heal. More severe breaks may not fully mend for 6 months. You and your doctor will decide when you are fully recovered.
  • Don't rush back into your activity too soon. If you start working out before your wrist is healed, you could cause more serious damage.
  • You may still have discomfort and stiffness in your wrist for months, or even years, after the injury.
  • Follow your doctor's instructions for taking care of your cast. Remember that casts cannot get wet.
  • See your doctor if the pain or swelling keeps getting worse after you get a cast or if you have numbness in your fingers.

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Colles’ Fracture Complications

If you get prompt treatment and good follow-up care for a Colles’ fracture, you can usually avoid complications.

Complications that can happen without quick treatment or with serious injuries include nerve or blood vessel injuries. Some people also develop compartment syndrome, a condition that happens when pressure in muscles gets dangerously high. These complications usually happen soon after the fracture.

Complications that can happen later include carpal tunnel syndrome and osteoarthritis. Sometimes the fracture doesn’t heal in the right position, and this can cause tendon injury and ongoing pain.

In more serious cases of Colles’ fracture, the following may happen:

  • The break extends into the wrist joint.
  • A piece of broken bone breaks through the skin.
  • The bone is broken in multiple places.
  • Bone pieces move out of place.
  • Bone pieces injure a blood vessel or nerve.
  • Ligaments may be torn.

These types of broken wrists may be harder to treat.

Colles’ Fracture Prevention

A broken wrist is tough to prevent, since it usually happens during an accidental fall. But it can help to use wrist guards during risky sports, like inline skating. Sometimes, a broken wrist can indicate osteoporosis, especially in women. Talk to your doctor about your risk factors for osteoporosis and fractures. There are steps you can take to improve your bone health.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 02, 2020

Sources

SOURCES:
American Academy of Orthopedic Surgeons web site: ''Distal Radius Fracture (Colles' Fracture).'' 
Davis, M.F., et al. Expert Guide to Sports Medicine, American College of Physicians Press, 2005. 
Rouzier, P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.
Small Fragment Set Manual: “The Wrist Joint.”
StatPearls:Colles’ Fracture.”
OrthoInfo (American Academy of Orthopaedic Surgeons): “Compartment Syndrome.”

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