Kinematics Team FAQ: Distal Radius Fracture (Colles’ Fracture)
October 21stDistal Radius Fracture Definition aka Colles’ Fracture. Your forearm has two bones. The radius sits on the thumb side and takes a fair amount of the load through your wrist when you lean on your hand.
A distal radius fracture is a break near the lower end of that bone, just above the wrist. “Distal” simply means further away from the centre of your body.
A Colles’ fracture is a particular type of distal radius fracture where the broken section shifts backwards, towards the back of your hand. When that shift is significant, the wrist can take on a noticeable bend or curve.
Some fractures can be put back into position and held there with a cast. Others need surgery, usually with a small plate and screws to keep the bone where it needs to be while it heals.
Where will I feel pain with a distal radius fracture?
The sore spot is usually fairly easy to find. It tends to be around the thumb side and back of the wrist, right over the injured area. Swelling and tenderness are common, particularly in the early days.
Then there is the bruising. It does not always stay neatly around the wrist. You might notice the colour creeping into your palm or fingers over the following week, going from purple to greenish-yellow as it settles. It can look pretty impressive by the time it gets there.
Pain can also show up on the little-finger side of the wrist. The ulna, which is the other bone in your forearm, can sometimes take a knock in the same fall. There is also a small cartilage structure on that side of the wrist which can become irritated, so twisting your forearm may feel particularly uncomfortable.
What movements will I struggle to perform if I have a fracture in my distal radius?
With a cast on, plenty of ordinary jobs suddenly become two-person jobs, or at least jobs that require a bit of creativity. Cutting up dinner, tying your hair, fastening clothing, or wringing out a face washer can all become surprisingly awkward.
And when the cast finally comes off, you may expect your wrist to feel normal again. It often does not.
After several weeks with very little movement, the wrist can feel stiff and unfamiliar. Turning your palm upwards is a common sticking point. That is the movement you use to catch coins, open a door with a key or tackle a stubborn jar.
Putting weight through the hand usually comes back later. Getting up from the floor, pushing yourself out of bed, leaning heavily through an armrest, doing a push-up or getting back to exercises such as downward dog all ask more from the wrist.
Will I feel pain in any other regions of my body?
Yes, sometimes. The wrist is not always the only thing that complains.
For weeks, you may find yourself carrying the injured arm close to your body without really thinking about it. Your shoulder and elbow can start to feel stiff, and the muscles around your neck may tighten from doing things a little differently.
Your fingers can have a hard time too. Swelling, reduced movement and simply keeping the hand still for long periods can leave them feeling sore and uncomfortable.
There are a few things that should not be brushed off, though. If your fingers become numb or tingly, change colour and become pale or blue, or your cast suddenly feels much tighter, contact your doctor or fracture clinic. The same goes if your pain is increasing rather than gradually settling.
Very occasionally, people develop more widespread pain and swelling, sweating or noticeable changes in skin colour around the injured area. It is uncommon, but it warrants early medical review.
How does a distal radius fracture happen?
Usually, the story starts with a fall and a hand that instinctively shoots out to break it.
It is a useful reflex but the force of the landing has to go somewhere. In this case, a lot of it can travel straight through the wrist and into the end of the radius.
For an older adult, the fall may not look particularly dramatic. A wet bathroom floor, an uneven footpath or missing a step can be enough.
What things should I try initially once I’ve distal radius fracture?
First up, follow the instructions from your fracture clinic or surgeon. They have seen your X-rays and can tell you what is appropriate for your particular fracture.
In those early days, swelling is one of the things you can actually do something about. When you are sitting down, prop your hand up on a couple of pillows. If you can get it above the level of your heart, even better.
Keep your fingers moving as well. Make a gentle fist, open the hand fully, then repeat it regularly throughout the day.
Unless you have been told otherwise, keep the elbow and shoulder moving too. You can use your good hand to help guide the injured arm through comfortable movements.
And make life easier where you can. Pump-pack soap, slip-on shoes, and food you can manage with one hand may sound like small things, but they remove a surprising amount of daily frustration while your wrist is out of action.
What things should I try to avoid in the initial stages of a distal radius fracture?
For now, the injured hand is not your lifting hand. Do not carry shopping, lift heavy things or lean your body weight through it until you have been cleared to do so.
Keep your cast or plaster dry. A waterproof cover is useful in the shower. And when the inevitable itch starts, do not reach inside with a ruler, knitting needle or anything else you can find. It is very easy to damage the skin underneath, and you may not know there is a problem until it has become one.
If you have been given a sling, try not to live in it unless your doctor has specifically told you to. Your shoulder still needs movement.
Driving is another one to check before you return to it. A cast can affect your ability to control the car, so speak with your doctor and check your insurance requirements first.
What type of exercises or movements do I need to learn to rehab the distal radius?
There is a natural order to wrist rehab. First you get the movement back. Then you build strength. After that, you gradually teach the wrist to handle load again.
At the beginning, that means working on bending and straightening the wrist, moving it from side to side and rotating the forearm. The palm-up movement is often one of the stubborn ones.
One simple option is to sit with your elbow tucked against your side and hold a wooden spoon. Slowly turn your forearm so the spoon moves through the available range. Nothing fancy. The important part is that the movement is controlled and comfortable.
Once movement is improving, grip becomes more important. A rolled-up towel or therapy putty can give you something to work with before you progress to bands or light weights.
Your hand also needs to become useful again, not just strong. Writing, typing, handling small objects and picking coins off a table all give you a chance to rebuild that coordination.
Then comes the load. You might start by resting some weight through the hand on a kitchen bench, move to wall push-ups, and eventually work towards getting onto all fours.
What you need at the end depends on your life. A tradie, tennis player and regular gym-goer do not need exactly the same wrist.
What other considerations contribute to fracture of distal radius?
Sometimes a broken wrist is also a prompt to look at the bigger picture.
If your wrist has fractured after what seemed like a fairly minor fall, particularly if you are a woman past menopause, your GP may recommend checking your bone density. This can help identify osteoporosis, where bones become thinner and more fragile.
It is also worth asking why you fell in the first place. Balance, leg strength, eyesight, medications and things around the home can all contribute.
There are some health factors worth addressing too. Smoking and low vitamin D can affect bone healing, while conditions such as diabetes can also influence recovery.
Looking at these things is not about dwelling on the fracture. It is about reducing the chance that the next fall becomes the next fracture.
What treatments can help relieve some pain or fast track my distal radius rehabilitation?
There is no shortcut around the time your bone needs to heal. Physiotherapy cannot make that biological process happen overnight.
What it can do is make sure the rest of your arm does not spend those weeks sitting on the sidelines.
Once your surgeon or fracture clinic has given you the green light, your physiotherapist will look at how your wrist and forearm are moving, how strong your grip is, whether there is swelling or altered sensation, and what you actually need your hand to do.
Because the goal is not simply “better wrist movement”. Maybe you spend eight hours a day typing. Maybe you garden every weekend. Maybe you need to lift your grandkids, return to the gym or get back to work with your hands.
Your rehab should reflect that. Depending on what you need, treatment may include hands-on work for stiff joints, strategies to manage swelling, scar massage following surgery, a removable splint for extra support and a home programme that changes as your capacity improves.
For some people, doing their exercises after warming the hand in water makes movement feel a little easier.
What are the expected timeframes of rehabilitating distal radius?
Bone generally takes around six to eight weeks to heal, with a cast commonly worn for four to six weeks. That does not mean your wrist is completely back to normal at six to eight weeks.
By two to three months, most people are managing everyday activities reasonably well. Strength and movement can continue improving for another three to six months. If you are returning to heavy lifting, contact sport or demanding gym work, expect the timeline to be longer.
Some stiffness can hang around for up to a year, particularly after a more complex fracture or in older adults. Try not to use somebody else’s recovery as your benchmark. Your starting point, fracture and day-to-day demands are your own.
If the wrist is still stiff, sore or weak once the cast is off, or it is getting in the way of work, driving, training or everyday life, an assessment can help work out what is holding you back and what to focus on next.
At Kinematics, we look at the whole picture and build your rehab around what you actually want to get back to.Elite care for the everyday, whether that means getting back to the gym, back to work or simply being able to use your hand without thinking about it.
This article is intended for general education only and is not a substitute for personalised medical advice, diagnosis or treatment.