What is a Colles fracture?
Colles wrist fracture refers specifically to a fracture of the distal end of the radius bone in the forearm, just above the joint with the carpal bones in the wrist. This kind of fracture is named after Abraham Colles whom first classified this type of fracture in a paper published in 1814.
What causes a Colles fracture?
A sudden impact to the wrist joint, with the wrist extended, such as when you put your arms out to stop a fall, is the most common way a Colles fracture occurs. Although any impact to the distal end of the radius with the wrist extended can have this effect, such as in a car accident or playing contact sports. There are other contributing factors that can increase your risk of Colles fracture including weakness from osteoporosis, vitamin deficiency and poor muscle strength and flexibility.
Above: Strengthening of the wrist following a colles fracture.What are the symptoms of a Colles fracture?
Common symptoms of Colles wrist fracture include;
- Sharp onset of pain at the moment of injury, or is the wrist is subsequently moved.
- Immediate swelling around the affected wrist.
- Redness and discolouration which deepens to bruising around affected wrist.
- Stiffness in joint from swelling of tissues and holding is still to prevent pain.
- Joint feels hot from inflammation reaction.
- Tenderness in the soft tissues around the affected joint.
- Deformity in normal wrist shape due to dislodged bone, sometimes producing distinctive ???dinner folk??? neck shape.
- Inability to make a fist or grip objects.
- Loss of sensation in part or all of the wrist and hand.
- Tingling or pins and needles sensation in wrist or hand.
- Altered sensation experienced in wrist or hand.
- Referred Pain up the arm, not usually higher than the elbow.
How is Colles fracture diagnosed?
Diagnosis of a Colles fracture will normally be done by your doctor when you present the injury. The diagnosis will be supported by the use of X-ray or MRI, which will confirm the presence and severity of the fracture. The examination will confirm the specific type of fracture which will affect how it is then treated. There are broadly four common types of fracture, they include;
- Intra-articular Fracture ??? Where the break occurs in the joint space.
- Extra-articular Fracture ??? Break occurs further up the bone, joint is unaffected.
- Comminuted Fracture ??? Leaves the bone in more than two pieces.
- Open Fracture ??? bone protrudes from the skin.
Above: Hand therapy following a coles fracture.What would a physiotherapy assessment for a Colles Fracture involve?
Once your wrist fracture has had time to begin healing, you will have follow up x-rays. When your ankle is strong enough, physiotherapy can help to strengthen and increase the mobility in your ankle and foot, and help you to slowly regain functional use of the wrist and hand.
An initial physiotherapy assessment will allow evaluation of your wrist, which lets us provide the most suitable treatment for you. At Liverpool Physio, your first appointment would be divided into two parts:
Subjective
A conversation between yourself and our physiotherapist to gain an understanding about your lifestyle and what you want to progress back to, the cause of your injury, and your progress since your fracture.
Objective
An assessment of your current pain, range of movement, functional movement and fine motor skills, scarring (if you have had surgery) and wrist / hand strength.
What would physiotherapy treatment for Colles fracture involve?
A Colles fracture is usually supported in a plaster cast for about six weeks to allow for the initial stages of bone healing. Physiotherapy following removal of this cast is vital to regain full functional movement and strength in your wrist and hand in a safe and effective way.
Our physiotherapists at Liverpool Physio are experienced at treating people following a Colles fracture and will reduce your pain, regain your range of movement, improve your muscle strength and return you to those activities you enjoy. Physiotherapy treatment at Liverpool Physio may include:
- Soft tissue massage to relieve tension and tight muscles
- Ice and heat therapy to relieve pain and stiffness
- Electrotherapy to promote soft tissue healing.
- Passive stretching to regain range of movement
- Active range of movement exercises to gradually improve strength and function
- Strengthening exercises, graduated and safe.
- Advice about how to modify activities whilst your fracture is still healing
- Gradual return to hobbies and sporting activities
- Wrist and hand sensation re-training if you suffered any nerve damage
If you would like more information about physiotherapy for a Colles fracture, or to book an appointment please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077.
How can I arrange a physiotherapy assessment for a Colles Fracture?
If you are experiencing pain or altered sensation in your wrist especially following an accident or injury, you may have a Colles wrist fracture. Seek emergency medical assistance from your GP or hospital, who will perform a detailed assessment with x-rays to determine the presence and severity of any fractures.
Your wrist will most likely be immobilised for a period of weeks in a cast or splint. Then the experienced physiotherapists here at Liverpool Physio can help with functional rehabilitation of your wrist, allowing your confident return to normal daily activities and sports.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I.
Summary
Colles fractures can present in a variety of different ways depending on their severity and how the surrounding tissues have been affected. The exact nature of the fracture will determine how your physiotherapist will treat it after the cast comes off. There are also a lot of nerves and vessels that pass across the wrist joint that can be affected causing additional symptoms. For these reasons it is import to get your wrist assessed as soon as your realise there is a problem.
Once assessed, the experienced physiotherapists as Liverpool Physio will ensure you get the best treatment for your injury. If you would like more information about physiotherapy for a Colles fracture, or to book an appointment please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077.
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