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Colles’ wrist fracture

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Colles fracture
Colles fracture

Alternative Names    Return to top

Transverse wrist fracture; Dinner-fork deformity of the wrist

Definition    Return to top

Colles' fracture is a break across the end of the main bone of the forearm (the radius). A Colles' fracture results in a backward and outward position of the hand in relation to the forearm.

Considerations    Return to top

Wrist fractures are common among children and the elderly. Children's bones are soft and tend to get buckle (torus) fractures, which are incomplete fractures on one side of the bone. Because bones become brittle with age, fractures are common among the elderly.

Wrist fractures most often occur when a person falls forward and then attempts to break the fall by throwing the hands forward. The impact of the hand on the ground and the sudden uptake of body weight by the wrist cause the ends of the radius and/or the ulna (the bones in the forearm) to buckle just above the wrist.

In older people, particularly those with osteoporosis, the radius may fracture just above the wrist, resulting in a backward angle. This is called a Colles' fracture.

The fracture may appear on an x-ray as a mild increase in density on the top side of the bone with a slight irregularity in the surface rather than a nice smooth line. Severe injuries will show evidence of a fracture through the entire bone.

Treatment may range from simple immobilization with a splint and sling to a lightweight fiberglass cast. If cast immobilization is insufficient to repair the fracture, surgery may be necessary and the break may need to be fixed with a plate and screws, pins, or an external fixation device.

Older people with Colles' fractures often fail to regain full mobility of the wrist joint. Carpal tunnel syndrome may occur as an early or late complication of the injury. Chronic pain may result from injury to the ligaments or the joint surface of the wrist. In addition, in older patients, the fracture is usually related to osteoporosis, so treatment for osteoporosis is advised.

Causes    Return to top

This injury is usually the result of trauma from a fall in which the person attempts to break the fall using the hands and arms. It is frequently associated with such sports as rollerblading, skateboarding, running, or any other activity in which the hands may be called upon to prevent a foreword fall occurring at relatively high speed.

Symptoms    Return to top

First Aid    Return to top

DO NOT    Return to top

The hand or the wrist should not be moved.

Prevention    Return to top

References    Return to top

Woolfrey KGH, Eisenhauer MA. Wrist and Forearm. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 48.

Update Date: 7/29/2008

Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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