Colles’ Fracture (Distal Radius Fracture). The most common wrist fracture after a fall

What Is a Colles’ Fracture?

A Colles’ fracture is the most common fracture of the distal radius, the forearm bone close to the wrist.

In this type of fracture:

• The broken end of the radius shifts towards the back of the wrist

• This creates a characteristic wrist deformity, often visible from the side

  
  

How Does a Colles’ Fracture Happen?

The most common causes include:

• Falling onto an outstretched hand

• Sports injuries

• Road traffic accidents

• Falls from height

This injury is especially common in everyday falls where the hands instinctively protect the body.

Symptoms

Typical symptoms include:

• Visible wrist deformity

• Strong, deep pain

• Swelling

• Redness

• Stiffness

• Tenderness to touch

Pain is usually intense and immediate.

First Aid – What to Do Right Away

If a Colles’ fracture is suspected:

1. Immobilise the arm immediatelyStabilise the forearm, wrist, and elbow using available items (a stick, cardboard, or wooden board) and secure them with a bandage or cloth.

2. Use a slingA temporary sling (for example, made from a scarf) helps unload the arm.Keep the wrist and hand in a neutral position.

3. Go to the emergency departmentAny injury that may be a fracture should be assessed by an orthopaedic doctor.

⚠️ Even fractures that seem stable can heal incorrectly. Poor bone alignment may lead to:

• Chronic wrist pain

• Loss of hand strength

• Reduced range of motion

• Wrist instability

Because the wrist is a complex joint, even small bone shifts can significantly affect hand function.

Do Not Ignore Warning Signs

Some people skip medical care, assuming it is “just a crack.” This is risky.

Do not avoid medical assessment if you have:

• Severe pain

• Increasing bruising

• Numbness or tingling in the fingers

• Loss of hand strength

Even small fractures can cause long-term problems in the body’s movement chains. Years later, untreated wrist injuries may contribute to:

• Chronic wrist or elbow pain

• Shoulder or neck pain

• Jaw pain

• Tinnitus (ringing in the ears)

• Dizziness

This is why proper diagnosis and physiotherapy are essential.

Diagnosis

Diagnosis is confirmed with:

• X-ray

• CT scan (when more detail is needed)

Treatment

Closed Reduction and Immobilisation

In most cases:

• The bone is repositioned using a closed reduction (without surgery)

• Local or general anaesthesia is used

• The wrist is then immobilised in a cast or splint for 4–6 weeks

A commonly used cast is the “sugar-tong” splint, which allows finger movement while stabilising the wrist.

Proper cast positioning is crucial to allow maximum possible hand function during healing.

Physiotherapy – Essential for Full Recovery

The main goal of physiotherapy is to restore hand and wrist function as quickly and safely as possible.

Rehabilitation depends on:

• Bone healing seen on follow-up X-rays

• Type of immobilisation used

• Patient cooperation and consistency

Early Phase (Immediately After Injury)

Focus:

• Reducing swelling

• Preventing blood clots

• Maintaining finger movement

Methods include:

• Elevating the arm above heart level

• Bandaging

• Lymphatic drainage

• Finger joint exercises

Older patients often avoid using the injured hand. Even in a cast, finger movement should be encouraged during daily activities such as eating or dressing. This greatly speeds up recovery.

Physiotherapists also teach proper use of a sling.

Middle Phase (6–8 Weeks)

Once bone healing is confirmed:

• More intensive exercises begin

• Focus on wrist bending and straightening

• Forearm rotation (supination) is restored gradually→ This is usually the most limited movement

Exercises may include:

• Free movements

• Light resistance

• Elastic bands

• Nerve gliding exercises to restore nerve mobility after immobilisation

Late Phase (8–12 Weeks)

Depending on progress, rehabilitation advances to:

• Strength training

• Weight-bearing exercises

• Functional and sport-specific movements

Tools may include:

• Medicine balls

• Dumbbells

• Barbells

• Exercises in multiple planes of movement

Supportive techniques may include:

• Kinesiology taping

• Flossing

• Pinotherapy

Important Notes About Recovery

Recovery timelines are individual and depend on:

• Bone healing

• General health

• Patient adherence to exercises

The fastest recovery usually occurs when:

• A rigid cast is replaced with a removable brace as soon as it is safe

• All joints of the arm are mobilised frequently

• There is good communication between patient, doctor, and physiotherapist

⚠️ Reduced immobilisation increases mobility but also requires responsibility to avoid re-injury.

When to See a Physiotherapist

You should seek physiotherapy if you:

• Have had a wrist fracture

• Feel stiffness or weakness after cast removal

• Want to return safely to work or sport

• Want to prevent long-term wrist problems

Early rehabilitation makes a huge difference.

Reference

Brotzman S. B., Wilk K. E. Orthopaedic Rehabilitation, Volume I. Elsevier, 2009.