Colles' Fracture - Diagnosis and Prognosis for a Broken Wrist

Monday, January 4, 2016

Falling down onto an outstretched hand is a common injury and often causes a broken wrist which doctors call a Colles' fracture.  The injury may be a simple fracture or a severe break with the bones pushed out of position.  Physiotherapists assess and plan the re-habilitation of a broken wrist, hand and forearm.


Diagnosis of a fracture is simple, as the area is often swollen and extremely painful.  It may look an odd shape which doctors call a dinner fork deformity and the doctor will be able to feel the broken bones.  


For correct healing a Colles' wrist fracture needs to be immobilised to hold the bones together in their original shape.  A simple break can be plastered and left to heal, but a displaced fracture in which the bones have shifted out of their normal alignment needs more attention.  

In these cases, you may need an operation so that wires, plates or screws can be used to fix the bones back into their original position.  Then the wrist is plastered to keep the bones from moving again.

Physiotherapy and prognosis

The plaster is generally left on for 5 – 6 weeks and then a skilled physiotherapist is needed.  When the plaster comes off, the condition of the wrist and hand can vary greatly and the physio will do an assessment and develop a treatment plan.

If you still have a lot of pain and swelling and the hand is discoloured this could indicate a Complex Regional Pain Syndrome (CRPS).  This is a very painful condition which needs expert physiotherapeutic treatment.

Regaining strength

The physio will assess whether the shoulder movement has become limited and then the rotary movements of the forearm will be evaluated.  These are key arm movements that can become limited and the physio will note the range of wrist flexion, wrist extension and finger and thumb movements.

If the therapist finds that the wrist fracture is healing correctly, a range of exercises to increase mobility for the wrist, forearm and hand will be started.  It is extremely important that you follow the exercise and joint mobilisation treatment plan carefully. 

Physio exercises have a huge effect on your prognosis and are designed to strengthen the wrist and allow you to resume your normal daily activities as soon as possible.  Doctors set bones, but only a physiotherapist can make them work normally again!

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