Diagnosing Colles Fractures
There are many different forms of Colles fracture, these wrist fractures can be classified into their different types based on the presence of a Colles fracture and any associated injuries. As stated in the previous blog Colles Fracture A Common Wrist Fracture injury history and some post trauma signs can alert one to the possibility of a Colles fracture being the suspected diagnosis and as previously mentioned in that blog given that this is a traumatic injury typically accompanied with visual wrist deformity and significant pain these sorts of wrist fractures usually (and should) present to an emergency department, not a physiotherapy practice! A physiotherapist involvement with Colles fractures is best left to the rehabilitation phase of the injury helping people get back to best once the fracture is healed and ready to be loaded again. Therefore physiotherapists treating a Colles fracture usually get involved once the individual has been cleared to start using and moving their hand and wrist by their fracture specialist.
Imaging For Wrist Fractures
Plain X-ray films often suffice for diagnosing a wrist fracture such as a Colles fracture. Although if there is suspicion, or concern regarding any intra-articular (joint) involvement then diagnostic CT imaging may also be used.
Some Associated Injuries With A Colles Fracture
Sometimes a Colles fracture is just that a fracture to the distal radius, but other times there is associated trauma to neighboring tissue, some examples of these include:
- An ulnar styloid fracture
- A Triangular fibrocartilage complex (TFCC) injury
- Carpal ligment injury, such as a scapholunate ligament tear
- Distal Radial Ulnar Joint (DRUJ) instability
- Median nerve injury/palsy
Prognosis And Treating A Colles Fracture
Multiple criteria will be taken into account when determining the best treatment option to proceed with. The majority of Colles fractures can be treated with closed reduction (non-surgical realigning of the wrist, verses surgical realigning which is referred to as open reduction). Following reduction the wrist is then immobilized for a period of time in a cast. The use of surgery when treating a Colles fracture and performing an open reduction and internal fixation (ORIF) is considered when the wrist fracture is unstable and/or there was unsatisfactory closed reduction results. Again these are all decisions made by a fracture specialist not a physiotherapist. Following a Colles fracture, patients frequently heal well without complication. Henceforth the ultimate goal when treating a Colles fracture is to return the wrist to its prior level of functioning but again this will depend on individual circumstances including both age, lifestyle, severity of fracture and any associated trauma as listed above.
Physiotherapy For Colles Fracture Rehab
The timing of any physiotherapy involvement in the treatment process can depend on the severity of the injury and how it was managed, be it via open or closed reduction. Often with open reduction where the fracture has been stabilized using internal fixation any mobilisation can begin earlier in the healing process than with closed reduction of the wrist fracture. During the period where the fracture is immobilised the goal is namely protection of the fracture site and positioning. Secondary to this is managing pain levels and reducing swelling whilst maintaining movement in neighboring joints and soft tissues. Early on in the rehabilitation phase the primary goal is to restore the individuals range of motion and ultimately progressing to introducing of strengthening exercises with graduated increase in activities of daily living and load bearing, moving towards a return to full pre-injury activity levels as appropriate.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Diagnosing And Treating A Colles Fracture Of The Wrist should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.