Colles Fracture

Colles Fracture

What is it?

A Colles Fracture refers to a break of the distal end of the radius. It was first described by Abraham Colles in 1814 who reported that the typical Colles Fracture will have the following characteristics;

·       A transverse fracture of the radius

·       Within 1 inch of the wrist

·       With dorsal displacement and dorsal angulation of the distal fragment.

What causes it?

Classically, a Colles fracture will occur when someone falls and lands onto their outstretched hand, however it can also be caused by direct impact to the extended wrist. Incidentally, the radius is the most commonly fractured bone in the arm. 

What are the Symptoms?

PAIN !

The first symptom as with most fractures is usually pain followed by acute swelling, bruising and tenderness. In a Colles fracture, the bone can sometimes hang out of place and create an obvious deformity. This deformity is often referred to as a ‘bayonet’ or ‘dinner fork’ deformity.

Management

As with all fractures, a Colles fracture will require immobilisation in a cast as a minimum. If the fracture is more severe then surgery may be required to pin and plate the bones into a more healthy alignment.

For the majority of wrist fractures a period of at least 6 weeks in plaster is required. Recently there is a shift towards removing a cast early and continuing to immobilise the wrist using a splint if necessary. The research indicates that this approach often accelerates the healing process.

As with all fractures that have been treated in plaster, the joint will be stiff and lacking mobility when the cast is removed. In most cases this will require Physiotherapy but not all clients get referred for treatment.

Pilates and Colles Fractures

Clients who have not received Physiotherapy treatment after having their plaster removed may benefit from some gentle exercises aimed at restoring good wrist movement and scapula stability. Anyone who has had their wrist immobilised for 6 weeks may also have developed discomfort in their shoulder from holding the arm differently. AGAIN – think of the body as a whole and assess the client’s needs without focusing entirely on the ailment. As such ... Pilates is perfect!

Obviously, it shouldn’t need to be mentioned that weight bearing through the wrist will be uncomfortable until the full range of motion and strength in the wrist is restored. Make sure to bare this in mind and work in alternative postures or off load the wrist using some small equipment.