A Colles’ wrist fracture occurs when the radius bone in your forearm breaks. It’s also known as a distal radius fracture, transverse wrist fracture, or a dinner-fork deformity of the wrist.
Your radius is the larger of the two main bones in your forearm. The distal part of the radius is the end near your wrist. When you have a Colles’ wrist fracture, the distal end breaks and can cause your wrist to bend in an abnormal way.
Depending on how severe the injury is, you’ll experience some degree of pain when you move your wrist. You might not be able to hold or grip anything, and your wrist will be swollen. You might also have bruising in this area.
This type of injury occurs more often in older people with brittle bones and in children, whose bones tend to be soft. It can be treated successfully with surgery, although recovery can be slow.
Your doctor will categorize your fracture according to how and where the bone broke. This helps determine what course of treatment you need. Types of fractures include:
- an open fracture (if the bone broke through your skin)
- a comminuted fracture (if the bone broke into more than two pieces)
- an intra-articular fracture (if the bone broke inside your wrist joint)
- an extra-articular fracture (if your joint isn’t affected)
Putting your hand out to stop yourself from falling can result in a Colles’ wrist fracture. Falling in this manner is the most common cause of this condition because you tend to land on your hand. Any type of injury that directly affects your wrist can result in a Colles’ wrist fracture.
You’re more at risk of having a distal radius fracture if you:
- have osteoporosis, a disease that weakens your bones (it’s associated with around 250,000 cases of wrist fractures, according to the American Academy of Orthopaedic Surgeons (AAOS, 2007)
- are elderly or have poor muscle strength or agility (these conditions make you more likely to fall)
- walk or do other activities in snow or on ice
- participate in activities that require a lot of forward momentum (such as in-line skating and skiing)
- have low muscle mass (this makes it harder for you to avoid falling)
- don’t get enough calcium or vitamin D (calcium helps build strong bones; vitamin D helps your body absorb calcium)
Over-the-counter medications, such as acetaminophen and ibuprofen, can help relieve pain. If the fracture isn’t severe, you can put the wrist in a splint and elevate it. Putting an ice pack on the injury also helps reduce swelling.
Don’t try to straighten your wrist and avoid moving it around. Schedule an appointment with your doctor as soon as possible or go to an urgent care center for medical treatment. If the pain is severe or if your wrist is numb, go straight to the emergency room.
If your fracture isn’t serious, your doctor might place your wrist in a lightweight cast and let it heal. Your doctor might need to straighten the bone depending on how it broke. This procedure, called a reduction, is done before your wrist is put in the cast. In most cases, the cast is taken off after six weeks.
If your wrist is severely fractured, your doctor will recommend surgery to correct it. Your bones will be straightened and held together using pins, a plate and screws, or an external device that holds the pins in place. After surgery, your wrist will be put in a splint or cast to keep you from moving it around too much as it heals.
Depending on how severe your injury is, you might have to work with a physical therapist. Your physical therapist will have you do exercises that can help rebuild the strength in your wrist and help you regain your normal range of motion.
A Colles’ wrist fracture can take a year or more to fully heal. Your cast will typically be taken off about six weeks after surgery. You should be able to do light activities about a month or two after your cast is removed. You can usually start doing more intense activities about three to six months after surgery.
Your wrist will probably feel stiff for about a month or two after the cast is off. You might continue to have slight aches or stiffness for about two years. Some people develop carpal tunnel syndrome after having a Colles’ wrist fracture. If you’re older, you might not be able to fully move your wrist around again.
Make sure you’re getting enough calcium by eating foods such as leafy, dark green vegetables, low-fat dairy products, and products that are fortified with this mineral. If your diet isn’t giving you enough calcium, you can make up for it by taking calcium supplements. You can get enough vitamin D from sunlight. If you don’t go outside much or use sunscreen every time you’re in the sun for any length of time, you may need additional vitamin D. Eating foods that contain vitamin D, such as salmon, can help you get the amount you need. If you can’t get enough from sunlight and your diet, you can take supplements.
Exercise helps make your bones and muscles stronger, which makes you less likely to fall and fracture a bone. The ideal workout should include weight-bearing exercises and strength training. Weight-bearing exercises, like jogging, strengthen the bones and muscles in the lower half of your body. Strength training routines, which include exercises like weight lifting, help the muscles and bones in the upper half.
If you’re going to be doing activities that raise your risk of having a Colles’ wrist fracture, wear a wrist guard. This helps protect your wrist if you fall.