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Colles' wrist fracture
Alternative namesTransverse wrist fracture
DefinitionColles' fracture is a break across the end of the main bone of the forearm (the radius) or both of the lower arm bones (the radius and ulna). A Colles' fracture results in a backward and outward position of the hand in relation to the forearm.
Wrist fractures are common among children and the elderly. Children's bones are likely to buckle because they are still growing and therefore are somewhat soft. Because bones become brittle with age, fractures are common among the elderly.
Wrist fractures most often occur when a person falls forward and then attempts to break the fall by throwing the hands forward. The impact of the hand on the ground and the sudden uptake of body weight by the wrist cause the ends of the radius and/or the ulna (the bones in the forearm) to buckle just above the wrist.
In older people, particularly those with osteoporosis , the radius may fracture just above the wrist and dislocates the wrist joint. This is called a Colles' fracture.
The fracture may appear on an X-ray as a mild increase in density on the top side of the bone with a slight irregularity in the surface rather than a nice smooth line. Severe injuries will show evidence of a fracture through the entire bone.
Treatment may range from simple immobilization with a splint and sling to a lightweight fiberglass cast. If cast immobilization is insufficient to repair the fracture, surgical intervention with internal fixation with pins, or a plate and screws may be necessary.
Older people with Colles' fractures often fail to regain full mobility of the wrist joint. Carpal tunnel syndrome may occur as a late complication of the injury. Chronic pain may result from injury to the ligaments or the joint surface of the wrist. In addition, in older patients, the fracture is usually related to osteoporosis, so treatment for osteoporosis is advised.
This injury is usually the result of trauma from a fall in which the person attempts to break the fall using the hands and arms. It is frequently associated with such sports as rollerblading, skateboarding, running, or any other activity in which the hands may be called upon to prevent a foreword fall occurring at relatively high speed.
The hand or the wrist should not be moved.
Update Date: 8/26/2002A.D.A.M. editorial. Previous review: Kevin B. Freedman, M.D., Department of Orthopaedic Surgery, Rush-Presbyterian Medical Center, Chicago, IL. Review provided by VeriMed Health Network (5/25/2001).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT