A distal radius fracture, or Colles’ fracture, is among the most common wrist fractures. It occurs when the radius, one of the two long bones in the forearm, breaks near the wrist. This injury often occurs from a fall on an outstretched hand and poses a higher risk to certain populations. Distal radius fractures rank among the most commonly treated fractures in emergency departments. According to the American Academy of Orthopaedic Surgeons, they account for nearly 18% of all fractures in adults.

Causes of a Distal Radius Fracture

A Colles’ fracture usually occurs due to a sudden impact on the wrist. The most common causes include:

• Falls: Falling onto an outstretched hand is the leading cause of distal radius fractures. This can happen during daily activities, such as slipping on a wet surface, or during recreational activities like skiing or ice skating.
• Sports Injuries: Contact sports, or sports that involve sudden impact or high speeds, can lead to a distal radius fracture. Football, basketball, snowboarding, and cycling are common culprits.
• Motor Vehicle Accidents: The high force involved in car accidents can cause significant wrist injuries, including distal radius fractures.
• Osteoporosis: In older adults, reduced bone strength due to osteoporosis increases the risk of fractures, even from a relatively minor fall.

Symptoms of a Distal Radius Fracture

Recognizing the symptoms of a distal radius fracture is crucial for timely treatment. Common symptoms include:

• Pain: Immediate pain is usually felt in the wrist area after the injury. The pain may be sharp and worsen with movement.
• Swelling and Bruising: The wrist and hand may swell rapidly, and bruising might develop around the site of the fracture.
• Deformity: In the case of a Colles’ fracture, the wrist may appear bent or out of alignment. This abnormal appearance is often referred to as a “dinner fork” deformity.
• Limited Range of Motion: Due to pain and swelling, it may be difficult to move the wrist, hand, or fingers.
• Numbness: Numbness or tingling in the fingers can occur if the nerves around the wrist are affected by the fracture or swelling.

Diagnosing a Distal Radius Fracture

If a distal radius fracture is suspected, prompt medical attention is essential. A healthcare provider or an orthopedic specialist will start with a physical exam, checking for tenderness, swelling, and any deformities. They will also assess the patient’s ability to move their wrist, hand, and fingers.

To confirm the diagnosis and determine the severity of the fracture, imaging studies are necessary. These studies may include an X-Ray or CT Scan.

Treatment Options

The treatment for a distal radius fracture depends on the severity of the injury, the patient’s age, activity level, and overall health. Treatment options range from non-surgical interventions to more invasive surgical procedures.

Non-Surgical Treatment

Many distal radius fractures can be treated without surgery, particularly if the bone fragments are still in alignment or can be repositioned. Common non-surgical treatments include:

• Casting or Splinting: In cases where the bone has not shifted significantly, a cast or splint may be applied to immobilize the wrist and allow the bone to heal. This option is often chosen for less severe fractures or for patients with lower activity levels.
• Closed Reduction: If the bone fragments are displaced but can be manually repositioned, a closed reduction may be performed. After the bone is realigned, a cast is applied to hold the bone in place during healing.

Surgical Treatment

Surgery may be necessary for more severe fractures, especially if the bone fragments are significantly misaligned or if the fracture extends into the joint. Common surgical procedures include:

• Open Reduction and Internal Fixation (ORIF): This is the most common surgical procedure for treating a distal radius fracture. The surgeon makes an incision to access the fracture, realigns the bone fragments, and secures them with metal plates, screws, or pins. This method provides stable fixation, allowing for early movement of the wrist and hand.
• External Fixation: In some cases, external fixation is used to stabilize the fracture. Pins are inserted into the bone above and below the fracture, and an external frame holds the bones in place while they heal.
• Percutaneous Pinning: For less severe fractures, percutaneous pinning may be used. Small wires or pins are inserted through the skin to hold the bone fragments in place.

Recovery and Rehabilitation

Recovery from a distal radius fracture can take several weeks to several months, depending on the severity of the injury and the treatment method used. Rehabilitation plays a critical role in regaining strength and mobility in the wrist and hand.

After the bone has healed, a structured physical therapy program may be recommended. This helps restore range of motion, improve strength, and reduce stiffness. Common rehabilitation techniques include:

• Range of Motion Exercises: Gentle exercises to improve flexibility in the wrist, hand, and fingers.
• Strengthening Exercises: Gradual strengthening exercises are introduced to rebuild muscle around the wrist and forearm.
• Pain Management: Ice, heat, and anti-inflammatory medications can help manage pain during recovery.

It is important to follow the rehabilitation plan closely to prevent long-term complications such as stiffness or reduced function.

Preventing a Distal Radius Fracture

While not all distal radius fractures can be prevented, there are steps that can reduce the risk, particularly for individuals at higher risk of falling:

• Bone Health: Ensuring good bone health is crucial, especially for older adults. A diet rich in calcium and vitamin D, along with weight-bearing exercises, can help maintain strong bones and reduce the risk of fractures.
• Fall Prevention: Simple measures such as removing tripping hazards at home, using handrails, and wearing non-slip footwear can help prevent falls, especially for the elderly.
• Protective Gear: For athletes and individuals engaged in high-risk sports, wearing protective wrist guards can help cushion the impact during falls.
• Strength and Balance Training: Exercises that improve balance and strength can reduce the likelihood of falls and fractures, particularly in older adults.

Long-Term Outlook for Distal Radius Fractures

With appropriate treatment, most individuals with a distal radius fracture can expect to recover fully. However, the long-term outcome depends on several factors, including the severity of the fracture, the treatment method, and the patient’s adherence to rehabilitation.

In some cases, patients may experience lingering stiffness, reduced grip strength, or limited wrist motion, especially if the fracture was severe or involved the joint. Regular follow-up with an orthopedic specialist is essential to monitor the healing process and address any complications early.

Schedule an Appointment with Dr. Karen Heiden

If you or a loved one has suffered a distal radius fracture or has ongoing wrist pain, expert care can make all the difference. Dr. Karen Heiden is an experienced hand and wrist specialist at Heiden Orthopedics and can provide you with the highest level of care. Whether you need a diagnosis, treatment, or rehabilitation for a wrist injury, Dr. Heiden can help you get back to doing what you love.

To schedule an appointment with Dr. Karen Heiden at our Salt Lake, Park City, or Heber City offices, call or chat with us today.