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Distal Radius Fracture / Wrist Colles Fracture

Fracture of the end (distal) of the radius is known as a distal radius fracture or wrist "Colles Fracture.” The distal radius is the end of the outer forearm bone and is the most common wrist fracture often occurring in postmenopausal women. The mechanism of injury is usually a fall on an outstretched hand resulting in a displacement or crush of the bone into itself.

The wrist Colles fracture/distal radius fracture results in a functional shortening of the radius and a resultant relative lengthening of the ulna (inner forearm bone) creating increased compression and altered movement at the wrist. We here at Cary Orthopaedics see this condition often through injured patients from Cary, Apex, Garner, Raleigh and the Triangle.

Wrist Colles Fracture/Distal Radius Fracture Management
Considerations for Chapel Hill, Cary, and other Triangle Patients

The management of a wrist Colles fracture/distal radius fracture is often dependent on many factors. Management may range from reduction of the fracture and casting to surgical fixation. Factors the physician should take into consideration include the general health, age and activity level of the patient. Secondly, is this injury on the dominant or non-dominant side and also the extent of the injury. Is the fracture site displaced or unstable ? There are other factors that must be considered as well in approaching this treatment either from a conservative or surgical approach. Your physician can guide you on the options.

Treatment Goals And Approach for a Wrist Colles
Fracture/Distal Radius Fracture

The ultimate goal of treating a wrist Colles fracture/distal radius fracture is to stabilize the fracture site in a good position so that appropriate healing may take place. Casting is normally the treatment of choice and may take 6 weeks to be fully healed. In the event that the fracture is displaced then the physician will most likely perform a "Closed Reduction" which means "resetting" the bones and is usually done under local anaesthesia. At times, the wrist Colles fracture/distal radius fracture is unstable, meaning that is will most not likely maintain good position with just reduction and casting. In this event an "Open Reduction" surgical procedure will be required. Typical methods of surgical open reduction involve the use of screws and plates, wires or external fixation devices that hold the fracture in place outside of the actual wrist.

Wrist Colles Fracture/Distal Radius Fracture Conservative
Treatment Considerations
Casting expectations

In the event that the conservative approach is taken, you will be placed in a short arm cast. Overall the arm, wrist and hand should feel comfortable in the cast but you may experience some short term pain and light pressure in the early stages of immobilization. It is important to inform your physician should you feel undue discomfort or recognize significant swelling in the fingers despite pain medicine and elevation of the arm. It is also important to move all joint of the upper extremity that can move while in the cast to prevent stiffness and encourage circulation.

Your treating physician will most likely re-x ray the arm with each office visit, especially in the early stages, especially if there is any concern about the stability of the fracture site. You may have 1-2 additional cast changes to ensure proper fit and comfort.

Post Immobilization Period Expectations for Wrist Colles
Fracture/Distal Radius Fracture Treatment

When healing is complete or nearly complete you will have your cast removed and will most likely be placed in a temporary and removable wrist guard. This can be removed for showering and you will be allowed to gradually wean from wearing this brace as comfort and healing time dictates.

Exercises will include range of motion at the wrist, elbow and fingers, grip strengthening using balls or theraputty and also eventually light dumbbell weights for forearm strengthening.

There most likely will be some residual stiffness and swelling around the wrist and into the fingers. With time, effort and therapy these symptoms gradually subside over the coming months.

Activity Considerations

Plan to refrain from any heavy lifting or sports for an additional 6 weeks after the cast has been removed. Avoid any risky activities that may predispose you to falling and avoid driving if you are not able to turn the steering wheel without pain.

For more information on how the wrist Colles fracture specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!

Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC