What is a Colle's Fracture?

Colle's Fracture refers to the fracture of the distal radius accompanied by posterior dislocation of the distal fragment. The fracture usually originates from falling with an outstreched hand. The deformity on the hand is obvious and many people refer to it as a broke wrist though the fracture is to the radial bone. Colle's Fractures were first described by Abraham Colles before evention of X-rays. These fractures are common among youths and the elderly.

There is a strong relationship between Colle's fractures and osteoporosis in the elderly. Therefore it is imperative to check for osteoporosis in the elderly presenting with Colle's fracture.

In the youths, these fractures are usually associated with high impact sporting activities.

In a patient presenting with a Colle's fracture, the hand resembles a dinner fork hence the term dinner fork deformity.

Characteristics/Presentation of Colle's Fracture

  • Dinner fork deformity
  • History of falling on outstretched hand
  • Wrist swelling
  • Increased andulation of the distal radius
  • Inability to grasp objects
  • Dorsal wrist pain (pain at the back of the wrist)

The following are signs and symptoms:

  • Pain
  • Swelling
  • Numbness
  • Bruising
  • Deformity of the wrist

Diagnosis of Colle's Fracture

Classic Colles fracture has the following characteristics;

  • Transverse fracture of the radius
  • 2.5 cm (0.98 inches) proximal to the radio-carpal joint
  • Dorsal displacement and dorsal angulation,together with radial tilt
  • Radial shortening
  • Radial angulation of the wrist
  • Loss of ulnar inclination/deviation
  • Communition at the fracture site
  • Associated fracture of the ulnar process in more than 60%% of the cases

Complications

  • Malunion
  • Shortening of radius
  • Persistence translation of carpus
  • Stiffness ofthe wrist and forearm
  • Occassionally carpal tunnel sydnrome
  • Sudeck's atrophy
  • Ulnar and radial compression neuropathy
  • persistent translation of the carpus shortening of radius stiffness of the wrist and the forearm

Management

Management of Colle's fracture depends on presentation of the patient. After initial medical management, the patient needs rehabilitation of the affected arm. Rehabilitation of the affected arm can be deivided into different categories such as:

  • Initial Phase
  • Subacute Phase
  • Settled Stage
NB: Physiotherapy management will focus on impairments and major goals of treatment include:
  • Reducing swelling
  • Reducing pain
  • Maintaining range of motion
  • Return to normmal function
  • Avoid contractures
  • Avoiding deformities
All finger and hand muscles, joints proximal as well as distal to the fractured site must be included in every rehabilitation programme.


Cardiopulmonary Physiotherapy
Chimwemwe Masina, PT

Author: Chimwemwe Masina

Chimwemwe Masina is currently working as a Resident Physiotherapist at DDT College of Medicine in Gaborone, Botswana. Before joining DDT College of Medicine, he worked in the Ministry of Health at Kamuzu Central Hospital in Malawi, MagWaz Physiotherapy and Wellness Services in Lilongwe, Malawi. as well as Volunteering at Physiopedia.
His interest is in Neuromusculoskeletal Physiotherapy and currently he is an assisting lecturer in Manual Therapy and Lumbar Spine Management.

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