A broken wrist after a fall - Distal Radius (Colles’) Fracture

A fracture is the same as a break!

If you have landed on an outstretched hand and your wrist is now painful, swollen, and oddly shaped, you may have broken the end of your forearm bone — a very common injury known as a distal radius fracture. It can feel alarming, but the good news is that most people make a full recovery with the right treatment.

What is it?

The radius is the larger of the two bones in your forearm. A distal radius fracture is a break near the lower end of this bone, close to where it forms part of your wrist joint. The term “Colles’ fracture” refers to the most common pattern, where the broken fragment tilts backwards, giving the wrist a characteristic “dinner fork” appearance. It is one of the most frequently seen fractures in any emergency department.

Why does it happen?

The most common cause is a fall on to an outstretched hand — the kind of instinctive reaction that happens when you trip or slip. The force travels up through the palm and concentrates at the end of the radius. In younger people the injury tends to result from higher-energy accidents such as sport or road collisions, whereas in older people even a low-energy stumble can cause a fracture, particularly if bone density is reduced (osteoporosis). Skiing, cycling, and contact sports are common settings in active adults.

When should I see a hand surgeon?

If your wrist is painful and swollen after a fall, you should seek assessment the same day — ideally in an emergency department so that an X-ray can be taken. You should be seen urgently if your fingers are numb or tingly, if the skin appears broken, if the deformity is severe, or if you cannot move your fingers at all. Once an initial assessment has been made, a referral to a hand and wrist surgeon is appropriate whenever the fracture pattern is complex, the wrist has a significant deformity, or early treatment has not restored a satisfactory position.

How is it treated?

Treatment depends on how displaced the bone fragments are. A stable, well-aligned fracture is usually managed with a plaster cast for around four to six weeks, followed by physiotherapy to regain movement and strength. If the fragments have shifted significantly, it may be necessary first to realign the bones — a procedure called a manipulation, carried out under local or general anaesthetic. Where the fracture remains unstable after manipulation, or where the joint surface is involved, surgery is often the best option. The most common operation uses a low-profile metal plate fixed to the bone, which holds everything in the correct position while healing takes place and allows earlier movement than a cast alone. Most patients regain excellent function, though full recovery can take three to six months.

If you have broken your wrist, or have concerns about how a wrist injury is healing, Mr Edwards offers specialist assessment and treatment at londonhandandwristsurgeon.com. Early expert review can make a real difference to your long-term outcome.