What is a Colles' Fracture?

A Colles' fracture is a common type of wrist break that affects the end of the radius bone in the forearm. Although many people call it a broken wrist, the injury actually happens just above the wrist joint, not in the small wrist bones themselves. The break often causes the wrist and hand to shift upward, creating a shape doctors call the "dinner fork" deformity. This distinctive bend makes the fracture easier to recognise. Understanding what a Colles' fracture involves helps ensure proper treatment and a smoother recovery.

How Does a Colles' Fracture Happen?

The most common way a Colles' fracture happens is by falling onto an outstretched hand—something doctors often call a FOOSH injury. When you instinctively reach out to break a fall, your hand hits the ground first. The impact force then travels up through your wrist and forearm. If your wrist is bent backward when you land, it can cause the end of the radius bone to snap and shift upward. This upward shift, called dorsal displacement, is a key sign of a Colles' fracture. While falls are the usual cause, these fractures can also result from more serious accidents like car crashes or sports collisions. How badly the bone breaks depends largely on how your wrist is positioned during impact and how much force is involved.

Who Is Most at Risk?

Women over the age of 60 are particularly at risk of Colles' fractures. This is often linked to osteoporosis, a condition where bones become brittle and fragile. Osteoporosis makes it easier to break bones from minor falls or impacts. Younger people can also suffer Colles' fractures, especially those active in sports like skiing, cycling, or skating. These injuries happen more from higher-impact trauma. In general, anyone who falls onto an outstretched hand or experiences wrist trauma can get this fracture, but age, bone health, and activity levels play a big part in risk.

Recognising the Symptoms

If you’ve broken your wrist with a Colles' fracture, the symptoms tend to be quite obvious. You’ll likely feel a sharp pain on the thumb side of your wrist, and swelling or bruising can show up pretty quickly. One of the clearest signs is the way your wrist and forearm might look bent upwards—this is often called the “dinner fork” deformity. Moving your wrist or fingers could become very difficult, and your grip strength may weaken a lot. Sometimes, you might notice numbness or tingling in your fingers if the nearby nerves are affected. It’s important to see a doctor quickly to get a proper diagnosis and avoid further problems.

Common symptoms include:

• Sharp pain on the thumb side of the wrist
  
• Swelling and bruising around the wrist and forearm
  
• Visible deformity with an upward bend ("dinner fork")
  
• Reduced range of motion and weak grip strength
  
• Possible numbness or tingling in the fingers
  
  

How a Colles' Fracture is Diagnosed

Diagnosis starts with a physical exam. The doctor looks for swelling, deformity, and tenderness. They check your wrist’s range of motion and test for nerve damage. The key to confirming a Colles’ fracture is imaging. X-rays from different angles show where the bone is broken and if the pieces have shifted. Sometimes, a CT scan is needed to get a clearer picture, especially before surgery. MRI scans are less common but can help assess soft tissue injuries like ligament tears.

Treatment Options for Colles' Fracture

Treatment depends on how bad the fracture is, your age, and your lifestyle. For simple fractures that haven’t moved much, doctors usually recommend immobilisation using a plaster cast or splint. This keeps the bone in place to heal naturally.

In more severe cases, surgery is needed. The surgeon realigns the bones and may use pins, screws, or plates to hold them in place. External fixators, which are frames outside the body, can also stabilise the bone. After surgery, a cast or splint is still worn for a few weeks.

Common treatments include:

• Immobilisation with plaster casts or splints
  
• Surgical fixation with metal pins, screws, or plates
  
• External fixation devices for severe fractures
  
• Pain management and anti-inflammatory medication
  
  

Recovery Timeline and What to Expect

Healing from a Colles' fracture usually takes around six to eight weeks in a cast. The exact time varies from person to person. After the cast is removed, you will likely experience stiffness and weakness. Full recovery, including regaining strength and flexibility, can take up to a year. Some complications may occur, such as wrist stiffness, malunion (bones healing in the wrong position), or nerve problems like carpal tunnel syndrome. Following your doctor’s advice during recovery is crucial to minimise these risks.

Also read : Impact of Tennis on the Wrist

Rehabilitation and Physical Therapy

Physical therapy is an important part of recovery. While immobilised, you should still move your fingers and thumb to prevent stiffness. After the cast comes off, exercises focus on restoring wrist movement and strength. Therapists use stretching, strengthening, and functional exercises to help you return to daily activities. Scar tissue management is also important if you had surgery to avoid tightness. Regular therapy sessions improve outcomes and reduce long-term stiffness.

Choosing the Right Wrist Support for Healing

When recovering from a Colles' fracture, it’s important to use the right wrist support to aid proper healing. A wrist brace or wrist splint should provide firm but comfortable stability to keep your wrist in place. Look for adjustable wrist braces that are lightweight and allow you to customise the fit. If your thumb also needs support, consider a thumb spica splint that stabilises both the wrist and thumb, helping to reduce strain on the injured area. Soft, breathable materials are best, especially if you’re dealing with swelling or soreness. The ideal support offers enough firmness to protect the wrist without being overly restrictive, so you can gently move and prevent stiffness. Always consult your healthcare provider or therapist to choose the most suitable support for your healing phase.

Preventing Colles' Fractures

Preventing all fractures is impossible, but you can reduce your risk. For older adults, treating osteoporosis and making homes safer helps prevent falls. Simple changes like removing rugs, improving lighting, and using handrails can make a difference. For active people, wearing wrist guards while skating or cycling offers extra protection. Learning how to fall safely can also help avoid serious injuries.

When to Seek Medical Help

If you injure your wrist and notice pain, swelling, deformity, or numbness, see a doctor immediately. Do not ignore wrist injuries because untreated fractures can heal poorly and cause long-term problems. If you cannot move your fingers or your wrist looks crooked, this is an emergency. Early diagnosis and treatment are key to better recovery.

Conclusion

A Colles' fracture is a common but serious wrist injury. It involves a break in the distal radius with an upward shift of the wrist bones. The classic "dinner fork" deformity helps identify it. Prompt treatment with casting or surgery is vital to restore function. Recovery requires patience, physical therapy, and care to avoid complications. Protecting your wrist and managing bone health can reduce the risk of future fractures.