Colles Fracture of Wrist or Distal Radius Fracture: Causes, Symptoms, Treatment

A Colles fracture^[1] of the wrist may also be called as fracture of the distal radius, wrist fracture, broken wrist, broken radius and fractured radius.

A Colles fracture of the wrist or distal radius fracture is a medical condition where there is a break in forearm bone termed as the radius. It is a type of wrist fracture where the bone gets displaced so that the wrist joint gets dislocated in the rear of its usual position.

The forearm consists of two long bones. These bones are called the radius and the ulna and radius which are located beside each other. Radius lies at the thumb side of the forearm forming joints with the ulna and many little bones at the wrist. Stress is placed on radial bone due to situations like landing on outstretched hands. If traumatic stress is placed on bone beyond its tolerable limits, this could result in fracture of radial bone.

Colles fracture of the wrist Colles fracture of the wrist or distal radius fracture is not only seen frequently in elderly people but also in children. The fracture of radial bone occurs usually in combination with fracture of other bones of the wrist and hand such as the scaphoid and ulnar bone.

Most frequently, Colles fracture of the wrist or distal radius fracture occurs as a result of a traumatic event like falling on outstretched hands. This could happen as a result of any type of fall but generally in sports. Aside from this, there can be other causes for Colles fracture of the wrist or distal radius fracture:

• Falls while doing activities like snowboarding can cause Colles fracture of the wrist or distal radius fracture etc.
• Patients suffering from osteoporosis^[2] could also be at a very high risk for Colles fracture of the wrist.
• Falls from skiing while holding on to a pole.
• Falls while playing sports like baseball, basketball etc.
• Falling down when skating can result in Colles fracture of the wrist or distal radius fracture.
• Bike accidents.
• Direct blow to wrist can also cause Colles fracture of the wrist or distal radius fracture.

A Colles fracture of the wrist or distal radius fracture may cause symptoms of sudden forearm or wrist pain instantly after injury. In addition, there are many other symptoms. Usually there is pain on wrist and forearm close to the thumb which sometimes calms down rapidly but leaves an achiness sensation, more prominent in the night or when waking up in the morning.

• Pain also is experienced while firmly touching the affected area of bone.
• Exacerbation of the pain while performing certain heavy activities in which wrist and hand is used like general gripping activities, placing weight through the affected hand such as doing push-ups and pushing the doors with the injured wrist.
• Swelling and bruising are common symptoms of Colles fracture of the wrist or distal radius fracture.
• Sudden pain may also appear at wrist.
• Pain and difficulty could be experienced during movements of the wrist.
• The break may also get extended in the joint of the wrist.
• The end of the broken bone protruding through skin, which could be a sign of compound fractures.
• Tearing of ligaments may also be caused by Colles fracture of the wrist or distal radius fracture.

If the injury causing Colles fracture of the wrist or distal radius fracture is painless without deformity in the wrist then the patient could wait till the next day. An ice pack can be applied to the wrist and a splint could also be used to protect the wrist till the time of examination.

If there is wrist deformity after the injury and is quite painful and numb or if the fingers are not pink, then it needs to be treated on an emergency basis and the patient has to be taken to the Urgent Care.

Nonsurgical treatment may involve several options for treatment usually depending upon factors such as the type of fracture, cause and age. Given below are few of the nonsurgical modalities of treatment.

The casting is applied to the broken bone which has maintained its normal position despite injury just to support it until it gets healed.

If there is displacement of bone from its usual alignment impairing usage of arm or wrist then the deformity may be treated with manipulation and reduction. This involves nonsurgical reduction of the bone using anesthesia or without it to restore it to its usual position. This method is known as closed reduction. Once the bone is aligned back to its normal position, a cast or splint may be applied.

When the bone deformity is to a degree such that it cannot be treated non-surgically then a surgical procedure is needed. The surgical procedure to treat and realign the bone to its usual position is called Open Reduction.

The procedure is done by creating an incision to expose the fracture in order to realign it to its usual position. This sometimes needs usage of pins, screws, or external fixator.

Physical therapy during the recovery phase of Colles Fracture of the Wrist or Distal Radius Fracture is imperative for individuals to hasten its healing and normalize the function of wrist and hand.

• Joint mobilization.
• Massage of the soft tissues.
• Dry needling.
• Ultrasound.
• Bracing.
• Use of ice and heat.
• Exercises to improve strength and mobility.
• Alteration of activities.
• Slow and gradual return to activities.

Recovery period or the healing time of Colles Fracture of the Wrist or Distal Radius Fracture depends on the severity of the fracture and the extent of deformity of the wrist bone in addition to timely treatment and physical therapy. There is a high possibility that the affected person may not get back full range of motion despite recovering from the injury. One can expect to recover from Colles Fracture of Distal Radius fracture in 6 to 8 weeks.

This exercise can be done by bending and straightening the elbow as far as possible until no pain is felt. It should be done 10 times without exacerbation of symptoms.

This type of exercise is done by placement of the forearm on some object and wrist and fingers over its edge. The wrist is then bent in the forward direction and then backwards slowly until no pain is felt. This needs to be done 10 times masking sure there is no aggravation of the symptoms.

This can be performed by bending 90 degrees with elbow towards the body. The palm is rotated in the upward and downward directions slowly as farther as possible till there is no pain felt. Again, it should be done at least 10 times without aggravation of symptoms.

This type of exercise is done by placement of the forearm on some object and wrist and fingers over its edge. The wrist is then bent from one side to the other slowly as farther as possible until there is no pain felt. It should be done at least 10 times without aggravation of symptoms of colles fracture of the wrist or distal radius fracture.

A detailed history and physical assessment is done for diagnosis of Colles fracture of the wrist. An x-ray is also done to confirm the severity of the fracture of distal radius.

Other Studies That Can be Done are:

• MRI
• CT

References: