Colles’ Fracture - Pictures, Treatment, Healing Time, Surgery, Symptoms
What Is Colles’ Fracture?
This is a specific type of broken wrist in which there is a break at the lower part of your radius bone close to your wrist. The radius bone is the lateral bone of your forearm that is located between your hand and elbow. This bone is always aligned with your thumb. When you talk about the lateral bone, it is the bone that is on the side of your body that is the farthest away from the mid-line of your body when your body is standing and facing forward, and your hands are also facing forward.
This fracture is one of the most common types of wrist fractures. Those most at risk are young children and older people who have osteoporosis. It is also known as a "distal radius fracture" because of where the break occurs in the arm.
The fracture is named after Abraham Colles, an Irish surgeon who was the first to describe the condition in 1814. He did this just by looking at a classical deformity, since this was before the advent of x-rays. One out of ten broken bone is usually a broken wrist.
Most Colles’ fractures can be put into four different categories, which are:
- Intra-articular - This is the type of fracture that will extend into your wrist joint.
- Extra-articular - This is when the fracture does not extend into your wrist joint
- Comminuted articular - This is where the fracture results in more than two pieces of bone.
- Open fracture - This is a fracture that pierces your skin.
When a person has a Colles’ fracture they will have swelling and intense pain. Their wrist may even be noticeably out of alignment or deformed looking. Other symptoms can include:
- Bone that protrudes through your skin
- Bruise on the wrist
- Tenderness in the wrist
- Wrist becomes very weak, and it becomes impossible to lift or grasp anything.
- In a severe break you will be able to see a bump above your wrist where the joint splits from the radius.
This fracture most often occurs when a person falls onto a hard surface and tries to break the fall or catch themselves by stretching out the arms—landing on outstretched hands with the palms turned upwards. It can also be caused by overusing the wrist, or by getting hit on the wrist. A person could also sustain this type of fracture in an accident; e.g., a car accident or a ski or bike accident.
Immediately after the injury, you should immobilize the wrist by either splinting or wrapping it until you can get to the emergency room to have it taken care of. You should also make sure to keep the joint elevated. To help ease the swelling and pain, keep an ice pack on it.
When you get to the emergency room, the physician on duty will give you some medication to help with the pain, and then they will examine your wrist. The physician will probably take x-rays so they can view the exact location of the fracture and the extent of the break. The physician will also check to see if there are any signs of ligament tears or nerve compression.
Depending on how severe the break is, the physician may decide to put your hand in either a hard plaster cast or in a soft splint to keep the wrist immobilized. If the bone has to be set it can be quite painful, so it is usually done by using anesthesia so you will not feel anything. If the area is swollen you may have to wear a splint for a few days, up to seven days, while you are waiting for the swelling to go down. Once the swelling has gone down the orthopedic physician will put on a hard cast.
For the first few days after your Colles’ fracture you should keep it elevated above the level of your heart to help ease the pain and swelling. You should also apply an ice pack for the first couple of days every 3-4 hours for 20-30 minutes. You should wrap the ice pack so your splint or cast does not get wet. For the pain the physician may give you a prescription for pain medication, or you can take over-the-counter pain-relief medication like Tylenol.
Post-Cast or Post-Splint Treamtment
When the hard cast or soft splint comes off your wrist will usually feel weak. It may even be sore. In order to regain the flexibility and strength of your wrist and hand your orthopedic physician may have you do low-impact exercises at home or in physical therapy. After successful treatment, your orthopedic physician may have you wear a wrist brace when doing any type of physical activity. With regular checkups and treatment, you should regain full use of your wrist.
Your orthopedic physician may suggest that you have surgery if the bone does not heal with just being put in a cast. If the break is severe you may have to have pins, plates, screws, or other devices in order to clamp the broken bone in place. This is done to make sure that the break heals properly.
Elderly patients with Colles’ fractures face a higher risk of complications. The reason is that there is no ability for them to have total recovery. The wrist could also lose its capacity to move to diverse extensions, making the movements completely stiff at the joint or just slightly restricted. Patients could also develop compressive neuropathy, which is a compression of the median or ulnar bone. Another potential complication is carpal tunnel syndrome, which is more prominent in the elderly patients. Dislocation fractures can also be associated with ruptured tendons. If this occurs, a graft of tendons may be necessary to help mend the ruptured tendon.
Normally you will wear a hard cast for 6-8 weeks, maybe even longer. If the break is a severe one it could take up to 6 months for it to completely heal. It all depends on how serious the break is.
If the cast was put on while your wrist was still a little swollen, you may need to have a second hard cast put on when the swelling goes completely down, and the hard cast becomes too loose.
While you are wearing the cast, make sure you do not try to do too much before your wrist has completely healed, because you could cause more serious damage. This continues to be very important right after you have the cast taken off. Even after it has fully healed you still may feel stiffness and discomfort in the wrist for months—and possibly years.