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Colles' fracture Images (Click to view larger image)
Alternative Names
wrist fracture, distal radial fracture
Definition
This condition involves a fracture, which is a break in the bones of the wrist. Fractures usually occur with a displacement, which means that the bones are out of their normal position.
What is going on in the body?
The wrist joint lies where the 2 bones of the forearm join the small bones of the hand. The wrist joint normally bends forward and extends backward. The forearm turns the palm up and down. A significant amount of force in any one of these directions can cause these bones to break.
What are the signs and symptoms of the condition?
Signs of a wrist fracture include swelling, deformity, tenderness, and bruising of the wrist. Symptoms are pain, stiffness, and inability to use the wrist.
What are the causes and risks of the condition?
Fractures occur when the force of an injury is greater than the strength of the bones and supportive tissues. People whose bones are weaker from disease such as osteoporosis or a previous injury are more prone to fractures
What can be done to prevent the condition?
Strong and healthy bones are the best defence against fractures from accidents. Bones are strengthened through exercise and proper nutrition. Vitamins and minerals such as vitamin D and calcium are important for strong bones.
How is the condition diagnosed?
Fractures are initially diagnosed based on the signs and symptoms a person may have. For example, the signs and symptoms of a severe fracture may include altered blood flow or a change in sensation to the fingers or hand with numbness or tingling. The diagnosis of a fracture is confirmed by an X-ray, which shows where the bones have been broken or displaced.
What are the long-term effects of the condition?
When treated properly, most fractures heal with minimal to no long-term effects. Possible long-term effects may include: - discomfort
- stiffness
- deformity, such as the shortening of one of the bones in the forearm
- arthritis
- numbness or tingling in the hand
- stiffness in the fingers
- a weak grip
- a total failure to heal
More serious long-term effects from a broken wrist can occur but are seen less often. Occasionally, tendons, tight cords of tissue that connect the muscle to the bone, can be caught in scar tissue or break over a rough bone. Rarely, a person will develop "shoulder-hand syndrome," which includes: - pain
- stiffness from the shoulder to the fingers
- bluish swelling of the hand and fingers
- weakness
- depression
What are the risks to others?
There are no risks to others.
What are the treatments for the condition?
Treatments to reduce pain and swelling are initially used after a fracture occurs. This includes medication, elevating the injury, and applying ice. The treatment then involves returning the bones to their proper position and re-aligning broken ends. A cast, which holds the repaired bones in place, is the most common treatment method. Sometimes a temporary splint is used to allow for swelling before a cast is put on. If the bones are not broken but are out of their normal position, they will need to be repositioned by the doctor followed by frequent check-ups.
Surgery may be necessary for a severe fracture, if the bones are not re-aligned properly, or if the skin is open. In rare cases a bone graft is used. A bone graft is when another piece of bone is used to replace a damaged bone. X-rays will need to be taken frequently to make sure the fracture is in a good position throughout the healing process. Exercises to maintain the flexibility of the fingers, elbow, and shoulder are also recommended.
What are the side effects of the treatments?
Sometimes the hand or arm swells so much that the cast or splint becomes too tight. When this happens the hand can become numb, or cold due to poor blood flow. If this occurs, the doctor may have to open the cast or loosen the bandage around the splint to allow for proper blood flow to the hand. In some cases, bones heal in a bad position or fail to heal completely. This can cause pain, stiffness, arthritis, or deformities. Sometimes while repositioning severely broken bones, small pieces of crushed soft bone develop and may cause more injury to the surrounding tissues. Infection or injury to other parts of the body due to surgery may also occur.
What happens after treatment for the condition?
Most wrist fractures heal without problems. Initially after the cast or splint is removed, the arm or wrist is pale and slightly weak from lack of use. Physiotherapy may be necessary to restore normal motion, strength, and function. Over time and with careful use, strength is gradually regained.
How is the condition monitored?
A person should monitor the fingers and wrist, especially after the first few hours and days following the injury and treatment. Any major swelling, numbness, tingling, or cool, blue fingers should be reported immediately to a doctor. The person should also check flexibility of the fingers, the elbow, and the shoulder, for stiffness.
Author:
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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