Colles' fracture

Colles' fracture is a type of bone fracture that occurs in the distal radius in the forearm. It is characterized by a specific break near the wrist, where the broken end of the radius tilts upwards. This fracture is most commonly associated with trying to break a fall with outstretched hands. The condition is named after Abraham Colles, an Irish surgeon who first described it in 1814 without the benefit of X-rays. Colles' fractures are particularly common in people with osteoporosis and in older adults, due to the decreased bone density that increases the risk of fractures.

Signs and Symptoms

Patients with a Colles' fracture typically present with pain, swelling, and deformity of the wrist. The deformity is often described as a "dinner fork" or "bayonet" appearance due to the dorsal displacement of the wrist and hand. There may also be bruising around the site of the injury. Limited range of motion and difficulty in wrist and hand function are common.

Causes

The primary cause of a Colles' fracture is a fall onto an outstretched hand (FOOSH). This mechanism of injury absorbs the impact through the wrist, leading to the fracture. Other risk factors include conditions that weaken the bones, such as osteoporosis, and participation in sports or activities that increase the risk of falls.

Diagnosis

Diagnosis of a Colles' fracture is primarily based on physical examination and the patient's history of the injury. Radiography (X-rays) is used to confirm the diagnosis, assess the fracture's severity, and plan for treatment. The X-ray images help in identifying the fracture's location, displacement, and angulation.

Treatment

Treatment of a Colles' fracture depends on the severity and complexity of the fracture. Options include:

• Non-surgical treatment: This approach includes the use of a cast or splint to immobilize the wrist and allow the bone to heal. Reduction, where the bone fragments are manually adjusted to their normal alignment, may be performed before immobilization.

• Surgical treatment: Surgery may be necessary for fractures that are severely displaced or unstable. Common surgical procedures include the use of metal pins, plates, and screws to hold the bone fragments in place until they heal.

Rehabilitation

Rehabilitation is an essential part of the recovery process. Once the bone starts to heal, exercises to restore wrist and hand function, strength, and flexibility are initiated. Physical therapy may be recommended to aid in recovery and ensure the best possible outcome.

Prevention

Preventive measures for a Colles' fracture include reducing the risk factors for falls and bone fractures. Maintaining good bone health through adequate calcium and vitamin D intake, regular exercise, and avoiding smoking and excessive alcohol consumption can decrease the risk of osteoporosis and subsequent fractures.

Complications

Complications from a Colles' fracture can include nerve damage, stiffness, and loss of wrist motion. In some cases, post-traumatic arthritis in the wrist may develop, leading to chronic pain and disability.