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. It’s named after Abraham Colles, who wrote a paper on this type of fracture in 1814.
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, which can cause your wrist to bend in an abnormal way.
This injury is very painful. 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 may 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:
- open fracture: if the bone broke through your skin
- comminuted fracture: if the bone broke into more than two pieces
- intra-articular fracture: if the bone broke into your wrist joint
- extra-articular fracture: if your joint isn’t affected
Causes and risk factors
Putting your hand out to stop yourself from falling is the most common cause of 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
- are elderly
- have low muscle mass or poor muscle strength, or lack agility and have poor balance (these conditions make you more likely to fall)
- walk or do other activities in snow or on ice, or do activities that require a lot of forward momentum, such as in-line skating and skiing
- have an inadequate intake of calcium or vitamin D
The most important treatment initially is immobilizing your wrist in a splint. You can simply use a magazine wrapped around your wrist to help support it. Elevate your wrist above the level of your heart to prevent further swelling. Putting an ice pack on the injury also helps reduce swelling.
Over-the-counter medications such as acetaminophen and ibuprofen can help relieve pain.
Don’t try to straighten your wrist, and avoid moving it around. Schedule an appointment with your doctor immediately, or go to an urgent care center for medical treatment. Go straight to the emergency room if the pain is severe or if your wrist is numb.
If your fracture isn’t serious, your doctor might place your wrist in a lightweight cast or splint and let it heal. They may need to straighten the bone if the fracture is displaced. This procedure, called a reduction, is done before your wrist is put in the cast. In most cases, the cast is taken off after a few 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, you may need to wear a splint or cast to immobilize your wrist and help with pain relief.
Depending on the severity of your injury, you might have to work with a physical therapist or occupational therapist. You’ll do exercises to help rebuild strength in your wrist and regain your normal range of motion.
A Colles’ wrist fracture can take a year or more to fully heal. Your cast will typically be removed about six weeks after surgery in a child, but relatively soon after surgery in an adult to mobilize the joint. You should be able to do light activities about a month or two after your cast is removed. Usually, you can start doing more intense activities about 3 to 6 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 a dull ache 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.
Make sure you’re getting enough calcium by eating dark, leafy green vegetables and low-fat dairy products fortified with calcium. 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. You may need additional vitamin D if you don’t go outside much or if you use sunscreen every time you’re in the sun. Eating foods that contain vitamin D, such as salmon, can help you get the amount you need. You can take supplements if you can’t get enough from sunlight and your diet.
Exercise helps strengthen your bones and muscles, which makes you less likely to fall and fracture a bone. Weight-bearing exercises such as jogging strengthen the bones and muscles in the lower half of your body. Strength training routines, which include exercises like weightlifting, target the muscles and bones in the upper half of your body.
Wear a wrist guard if you do activities that raise your risk of getting a Colles’ wrist fracture. It will help protect your wrist if you fall.