A Colles' fracture is a break in the distal radius, which is the larger of the two bones in the forearm. Because the distal radius usually breaks approximately 1 inch from its end, which is close to where it connects to the bones of the hand near the thumb, the injury is usually referred to as a "broken wrist." In the United States, Colles' fractures account for approximately 70 percent of all forearm fractures, and are typically the result of landing on a hand that has been extended to break a fall, or of a sports-related injury. In addition, the elderly are prone to Colles' fractures (as are those who have osteoporosis) because of the fragility of their bones.
The fracture is named after Irish surgeon and anatomist Abraham Colles, who was the first to describe this type of wrist fracture, in which the broken fragment of the radius tilts upward.
Signs of a Colles' Fracture
Colles' fractures are more common in women than men. Symptoms of Colles' fractures include the following:
- Immediate pain, particularly during wrist flexion
- Crooked- or bent-looking wrist
To diagnose a Colles' fracture, a physical examination is performed and X-rays taken to see the severity and exact location of the break.
Treatment of a Colles' Fracture
Depending on the severity of the Colles' fracture, treatment varies. If the bones are in good alignment, a plaster cast may suffice. If the bones are out of alignment, they will need to be reset, either by a doctor's moving the broken bones by hand or during surgery. In both cases, a splint is worn for a few days until swelling goes away; at that point, a plaster cast is put on. The cast is usually removed within 6 weeks, and physical therapy to strengthen the wrist prescribed.
Surgery is required when the Colles' fracture cannot be repaired by placing the wrist in a cast alone. During surgery, the bones are aligned, and then held in place with plates or screws, metal pins, an external stabilizer or a combination thereof. A cast may also be used; if so, it is left in place for approximately 6 weeks. An open Colles' fracture, in which the bone protrudes through the skin, requires immediate (within 8 hours) surgery. After it has healed, physical therapy is required for either a closed or open fracture.