Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Fracture of the Distal Radius and Ulna

A fracture of the distal radius (Colles’ fracture) is the most common of all fractures. It usually occurs as a result of a fall on the extended arm, forcing the hand backwards and upwards. A less common injury is Smith’s fracture where the mechanism is a forward flexion (palmar flexion) of the wrist. The injury is not uncommon among ice hockey, soccer, rugby, and team handball players, riders, wrestlers, alpine skiers, and others.

Symptoms and diagnosis

– ‘Dinner fork’ deformity of the wrist is characteristic of Colies’ fracture. The position is caused by the fractured fragment of the distal radius being driven backwards (dorsiflexed) in relation to the forearm. In Smith’s fracture a forward (palmar flexion) dislocation of the distal radius is present.
– Swelling and tenderness occur in the wrist.
– Pain is felt on wrist movements.
– In milder cases, swelling and displacement may be minor. The injury may then be mistaken for a sprain, but when this is so, the wrist should be X-rayed to reveal any bony injury.

Treatment

The doctor may:

– restore the fractured ends of the bone to their correct position;
– apply a plaster cast (usually a splint or brace which can be removed after 4–5 weeks if the fracture is uncomplicated). The wrist is later strengthened by training;
– operate in cases of more serious fractures.

Healing

Conditioning can often be maintained during immobilization of the wrist. Other forms of sporting activity involving the wrist can be resumed after 8–12 weeks.

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