Distal radius fractures are common injuries. An older name for them is a Colles fracture, named after the doctor who described the typical deformity of this break in 1814. A break, or a broken wrist, is another term for a fracture and means the same thing.

Distal Radius

The radius is the forearm bone on the thumb side. It has an end surface that forms part of the wrist joint.

Fractures

Injuries commonly happen by a simple fall onto the outstretched hand. There are many different variations, so the name Colles fracture does not cover all these differences. Most involve the end few centimetres of bone near the wrist joint.

Treatment

Cast

Many fractures need only a cast. Some need monitoring with a sequence of X-rays to ensure the fracture remains the best shape for good long term function. Complications such as tendon irritation, stiffness, and carpal tunnel syndrome also need to be prevented and treated if needed.

Surgery

Some fractures require an operation to reduce, that is, to put the broken bones back into their correct position. When a reduction is necessary, the surgeon will commonly insert a plate and screws to hold the fracture reliably in place while it heals. Good function usually follows when a fracture heals in a good position, and when a patient has higher functional demands the fracture often needs to be restored as closely as possible to its original shape.

Complex Fractures

At times there can be complex fracture involving the joint surface that need advanced techniques such as arthroscopic assistance to achieve a good result. Soft tissue injuries such as scapholunate ligament tears, and distal radioulnar joint instability need to be examined for.

Ulna Styloid

It is common to see a small pice of bone detached from the end of the ulna, the smaller little finger side forearm bone. This rarely needs any surgery or treatment. It often is healed with soft tissue rather than bone bridging the gap, but this rarely causes problems. The small piece of bone is not floating around.

Ulnar Sided Wrist Pain

Some pain on the little finger or ulnar side of the wrist is common for up to 6 months. This is due to a soft tissue injury associated with the fracture. There is a shock absorber tissue called the triangular fibrocartilage in this area. It is often torn at the same time as the distal radius fractures, but will almost always become pain free over time. Occasionally an arthroscopic debridement is needed if it does remain sore after 6 months.