Colles’ Wrist Fracture


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Definition

Colles' fracture is a break across the end of the main bone of the forearm (the radius). A Colles' fracture causes the wrist to become extended and shortened.


Alternative Names

Transverse wrist fracture; Dinner-fork deformity of the wrist


Considerations

Wrist fractures are common among children and the elderly.

  • Children's bones are soft and tend to get buckle (torus) fractures. These are incomplete fractures on one side of the bone.
  • Because bones become brittle with age, a complete fracture is more likely in adults and among the elderly. This is called a Colles' fracture.

Fractures that are not severe may be placed in a splint and sling, or a lightweight, fiberglass cast.

If the bone is no longer straight because of the fracture, it must be reduced (straightened).

  • The health care provider may be able to use local anesthesia and reduce the fracture.
  • In other cases, surgery may be needed. The break may need to be fixed with a plate and screws, pins, or other metal or plastic hardware.

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.


Causes

This injury usually occurs when a person attempts to break a fall by throwing the hands and arms out in front of them. The hands meet the ground with the body weight behind them. The radius and ulna (the bones in the forearm) may buckle or break just above the wrist.

This injury is more likely to happen during sports such as rollerblading, skateboarding, running, or any other activity in which a forward fall can occur while a person is moving at a higher speed.

Bones become more brittle (from osteoporosis) in adults ages 50 - 60 and older. Older adults are more likely to fracture a bone, even while walking slowly.


References

Woolfrey KGH, Woolfrey MR, Eisenhauer MA. Wrist and forearm. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 48.

Mercier LR. The forearm, wrist, and hand. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 7.


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Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington School of Medicine; and C. Benjamin Ma, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Last Updated 6/7/2011
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