Colles’ Fracture in Adults: Causes, Treatment, and Prevention Tips

By DR.AHMED RAOUF -

 

For practical guidance on bone and joint problems, check out my book  here 

https://www.amazon.com/stores/Ahmed-Raouf/author/B0GJ18M76D/allbooks?ccs_id=7bd58c8e-4198-4c4a-b3bb-4d731aeaf7f1

A Colles’ fracture is one of the most common wrist fractures, particularly in adults and the elderly. It involves a break in the distal radius (the larger of the two forearm bones) just above the wrist joint, typically with a characteristic backward (dorsal) displacement of the hand.

Colles’ Fracture

 Colles’ Fracture


The injury is named after Abraham Colles, who first described it in 1814.

Causes of Colles’ Fracture

1. Fall on an Outstretched Hand (FOOSH)

The most common mechanism is a fall where the person instinctively extends the hand to break the fall. This transmits force directly to the wrist, leading to fracture.

2. Osteoporosis

Reduced bone density—especially in postmenopausal women—makes bones more fragile and prone to fracture, even with minor trauma.

3. Direct Trauma

High-impact injuries such as road accidents or sports trauma can also result in this fracture.

Symptoms and Signs

  • Severe wrist pain immediately after injury
  • Swelling developing within hours
  • Visible deformity (often described as a “dinner fork” or dorsal angulation)
    dinner fork deformity of wrist
    dinner fork deformity of wrist

  • Limited movement or inability to use the wrist
  • Tenderness over the distal radius

Diagnosis

Clinical Examination

  • Assessment of pain, swelling, deformity, and range of motion

Imaging

  • X-rays: Confirm the fracture and determine displacement
  • CT scan (in complex cases): Evaluates joint involvement and fracture pattern

Treatment Options

1. Non-Surgical Treatment

  • Closed reduction: Realigning the bone without surgery
  • Immobilization: Using a splint or cast for 4–6 weeks

This approach is suitable for stable, minimally displaced fractures.

2. Surgical Treatment

Indicated in unstable or significantly displaced fractures.

  • Open Reduction and Internal Fixation (ORIF): Using plates and screws
    plate and screw coll.s fracture
    plate and screw coll.s fracture

  • Percutaneous pinning: Stabilizing the fracture with wires without fully opening the site

Rehabilitation and Physical Therapy

Rehabilitation is essential after cast removal or surgery to restore function.

Goals:

  • Improve muscle strength
  • Restore range of motion
  • Enhance flexibility
  • Reduce pain and swelling

Recovery duration depends on fracture severity and patient age.

Possible Complications

  • Joint stiffness after immobilization
  • Malunion (healing in improper alignment)
  • Early osteoarthritis
  • Nerve injury, causing numbness or weakness (e.g., median nerve involvement)



Prevention Tips

1. Maintain Bone Health

  • Adequate intake of calcium (1000–1200 mg/day)
  • Sufficient vitamin D

2. Prevent Falls

  • Improve home safety (remove loose rugs, ensure good lighting)
  • Use assistive devices if needed

3. Regular Exercise

  • Focus on balance, strength, and flexibility training

4. Follow Medical Advice

  • Adhere to rehabilitation programs
  • Avoid excessive stress on the wrist during recovery
  • Schedule follow-up visits to monitor healing

Conclusion

A Colles’ fracture is not a minor injury—it requires prompt diagnosis and appropriate management to prevent long-term complications. Early treatment, proper rehabilitation, and preventive strategies play a crucial role in restoring normal wrist function and reducing the risk of future fractures.

References

  • Rockwood and Green's Fractures in Adults
    • Court-Brown CM, Heckman JD, McQueen MM, Ricci WM, Tornetta P.
    • 8th Edition. Wolters Kluwer, 2015.
    • (Comprehensive reference for distal radius fractures including Colles’ fracture)
  • Campbell's Operative Orthopaedics
    • Azar FM, Beaty JH, Canale ST.
    • 13th Edition. Elsevier, 2017.
    • (Detailed surgical and non-surgical management of wrist fractures)
  • American Academy of Orthopaedic Surgeons
    • Distal Radius Fractures (Broken Wrist)
    • Available at: https://orthoinfo.aaos.org
    • (Patient-friendly and clinician-reviewed guidelines)
  • National Institute for Health and Care Excellence
    • Fractures (non-complex): assessment and management
    • Available at: https://www.nice.org.uk
    • (Evidence-based clinical guidelines

    • About the Author: Dr. Ahmed Raouf

    Dr. Ahmed Raouf is a highly experienced Orthopedic and Joint Surgery Consultant with over two decades of dedicated practice. His career includes significant tenures at prominent hospitals within the Egyptian Ministry of Health and Mousat Hospital in KSA. He specializes in Knee Osteoarthritis & Joint Replacement, Sports Injuries & Ligament Reconstruction, Fracture Management & Trauma Surgery, and Chronic Back & Shoulder Pain Solutions.

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