Colle's fracture is a fracture of the distal radius near the wrist joint. It most commonly occurs in postmenopausal women over 40 years old from falls on an outstretched hand. Clinical features include pain, swelling, and the classic "dinner fork deformity". Treatment involves closed or open reduction and casting for 4-6 weeks. Physiotherapy focuses on regaining range of motion, strength, and function. Complications can include nonunion, stiffness, or nerve damage if not properly treated.
2. Definition
• It was first described by Abraham colles in 1814.
• Colles fracture is the fracture at the distal end of radius, at its cortico cancellous
junction(about 2cm from the distal articular surface). It is not just the fracture of
distal radius but the fracture dislocation of the inferior radio-ulnar joint.
• Most common age group is above forty years, occuring most commonly in
women.
4. Causes
Have osteoporosis, a disease that weakens your bones
Postmenopausal osteoporosis.
Commonest skeletal injury In Elderly.
Have low muscle mass, poor muscle strength, or lack agility (these conditions
make you more likely to fall)
Walk or do other activities in snow, on ice, or that require a lot offorward
momentum, such as in-line skating and skiing
Have an inadequate intake of calcium or vitamin D
Road Traffic Accident, fall from height.
5. Clinical features:
• Pain : arm was held close to body
• Swelling
• Deformity- There is classic ‘dinner-fork deformity’ seen in colles’ fracture.
• Radial styloid process lies in the same level or little higher than the ulnar styloid
process.
6. Types of Colle's Fracture
• Open fracture: If the bone broke through yourskin
•Comminuted fracture: If the bone broke into more than two pieces
• Intra-articular fracture: If the bone broke inside your wrist joint
• Extra-articular fracture: If your joint isn’taffected
7. Complications
Early complication includes
Swelling and Pain in the Finger
Median Nerve compression
Sudek's Atrophy
Late Complication
Malunion
Non union of the ulnar styloid process.
Rupture of the Extensor pollicislongus.
Stiffness
Shoulder hand syndrome
8. Treatment
Undisplaced Fracture- A dorsal Splint for 1-2 days to remove swelling and cast will
be Placed for 4 week to stabilize joining.
9. Treatment
• Displaced Fracture –
Reduction of the fracture under anesthesia and correct the Bone alignment. Then
Dorsal Plaster Slab is applied.
• Comminuted Fracture-
Percutaneous K-wire fixation along
with Plaster Immobilization. It then
Remove
after 5 weeks.
10. Physiotherapy Treatment
Main role of Physiotherapy is in rehabilitation Stage.
• Objectives of rehabilitation
1. Maintain joint range of motion
2. Increase muscle strength
3. Improve functional ability
11. Exercise Programme
During reduction plaster cast –
Uninvolved joint active rang of motion
Wrist joint passive supination & pronation
•Isometric hand muscle exercise
Continue After removal the cast
- Mobilized the affected wrist
- - Start some strengthening exercise
- - Start weight bearing exercise
- Later stage Advance exercise ,full weight bearing exercise.
12. Prognosis
• Expected time for healing 6th to 8th weeks until the fracture is stable. • Earlier
treatment usually improves the result .
• Chronic disease such as - Osteoporosis and Diabetes may slow the healing time