• Colles' Fracture

    (Fracture, Distal Radius; Distal Radius Fracture; Transverse Wrist Fracture; Dinner-Fork Deformity of the Wrist)

    Definition

    A colle's fracture is a break in the distal part of the radius bone. The radius is one of the bones of the forearm. The distal end of the bone is considered part of the wrist. Distal radius fractures are categorized by type:
    • Open fracture—a broken bone that breaks through the skin
    • Comminuted fracture—a bone that breaks into more than two pieces
    • Intra-articular fracture—a broken bone within a joint
    • Extra-articular fracture—a broken bone that does not involve the joint
    Intra-articular Colle's Fracture
    Colle's Fracture
    Copyright © Nucleus Medical Media, Inc.
    This sheet focuses on fracture of the distal radius. Fractures of other wrist bones can be found on a separate sheet.

    Causes

    The most common cause of a distal radius fracture is a fall on an outstretched hand. It can also be caused by:
      Direct blow to wrist:
      • Car accident
      • Falling off a bike
      • Skiing fall
    • Other trauma

    Risk Factors

    Factors that can increase your risk of breaking your radius bone include:
    • Osteoporosis
    • Poor nutrition
    • Conditions that increase the risk of falling:
      • Snow
      • Ice
      • Loss of agility or muscle strength
    • Increased age
    • Postmenopause
    • Decreased muscle mass

    Symptoms

    If you have any of these symptoms do not assume it is due to a distal radius fracture. These symptoms may be caused by other conditions.
    • Arm or wrist pain
    • Bruising
    • Swelling
    • Tenderness
    • Severe pain with movement
    • Trouble moving wrist or arm
    • Wrist appears out of line

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist. An orthopedist focuses on bones.
    Images may need to be taken of your wrist or arm. This can be done with an x-ray.

    Treatment

    It takes 6-10 weeks for a fracture of the radius at the wrist to heal. The type of treatment you receive depends on where you broke your bone and how serious the break is.
    Some fractures require a reduction. This means the doctor realigns the bones before healing begins. Reductions can be done by the doctor moving your arm into position or through surgery.
    Your doctor may choose to treat the fracture using a cast. Your cast may be removed after a few weeks and replaced if it loosens. Most casts are removed at about six weeks.
    In other cases, a splint or a soft bandage may be used instead of a cast. Talk with your doctor about the best plan for you.

    Medication

    Your doctor may prescribe a pain medicine or suggest an over-the-counter pain reliever.

    Surgery

    A distal radius fracture sometimes requires surgery. The surgeon first realigns the bones with a reduction. Then, any of the following may be used to hold the bones together as they heal:
    • A plate and screws
    • Pins
    • An external device that holds the inside pins together
    You may be given a splint to wear after surgery to keep your arm from moving too much.

    Physical Therapy

    You will probably work with a physical therapist. They can help you regain range of motion and strength.

    Prevention

    To help reduce your chance of fracturing your radius bone, take the following steps:
    • Practice good nutrition for bone health, including adequate amounts of calcium and vitamin D .
    • Consider wearing a wrist guard when you play sports that put you at risk, such as in-line skating.
    • Keep your muscles strong to prevent falls.

    RESOURCES

    American Academy of Family Physicians http://familydoctor.org

    American Academy of Orthopaedic Surgeons http://www.aaos.org/

    American Physical Therapy Association http://www.apta.org

    CANADIAN RESOURCES

    The Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Distal radius fracture. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00412 . Updated August 2007. Accessed March 4, 2013.

    Distal radius fracture. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 17, 2012. Accessed March 4, 2013.

    5/6/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Kropman RH, Bemelman M, Segers MJ, Hammacher ER. Treatment of impacted greenstick forearm fractures in children using bandage or cast therapy: a prospective randomized trial. J Trauma. 2010;68(2):425-428.

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