Colles wrist fracture - aftercare

A Colles wrist fracture is caused by a forceful injury to the wrist. This may occur due to:

• Car accident
• Contact sports
• Falling while skiing, riding a bike, or other activity
• Falling on an outstretched arm (most common cause)

Having osteoporosis is a major risk factor for wrist fractures. Osteoporosis makes bones brittle, so they need less force to break. Sometimes a broken wrist is the first sign of weakening of the bones.

You will likely get a splint to keep your wrist from moving.

If you have a small fracture and the bone pieces do not move out of place, you will likely wear a splint for 3 to 5 weeks. Some breaks may require you to wear a cast for about 6 to 8 weeks. You may need a second cast if the first one gets too loose as the swelling goes down.

If your break is severe, you may need to see a bone doctor (orthopedic surgeon). Treatments may include:

• Closed reduction, a procedure to set (reduce) a broken bone without surgery
• Surgery to insert screws and plates to hold your bones in place or replace the broken piece with a metal part

To help with pain and swelling:

• Elevate your arm or hand up above your heart. This can help reduce swelling and pain.
• Apply an ice pack to the injured area.
• Use the ice for 15 to 20 minutes every few hours for the first few days while the swelling goes down.
• To prevent skin injury, wrap the ice pack in a clean cloth before applying it rather than putting it directly on your skin.

For pain, you can take over-the-counter ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines without a prescription.

• Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle.
• Do not give aspirin to children.

For severe pain, you may need a prescription pain reliever.

Follow your provider's instructions about elevating your wrist and using a sling.

• If you have a cast, follow the instructions for your cast that your provider gave you.
• Keep your splint or cast dry.

Exercising your fingers, elbow, and shoulder is important. It can help keep them from losing their function. Talk with your provider about how much exercise to do and when you can do it. Typically, the provider or surgeon will want you to start moving your fingers as soon as possible after having surgery or the splint or cast put on.

The initial recovery from a wrist fracture can take 3 to 4 months or more. You will need physical therapy.

You should start working with a physical therapist as soon as your provider recommends. The work may seem hard and at times painful. But doing the exercises you are given will speed your recovery. If you have surgery, you may start physical therapy earlier to avoid wrist stiffness. However, if you don't have surgery, you may start wrist motion later to avoid shifting of the fracture.

It can take anywhere from a few months to a year for your wrist to fully recover its function. Some people have stiffness and pain in their wrist for the rest of their life.

After your arm is placed in a cast or splint, see your provider if:

• Your cast is too loose or too tight.
• Your hand or arm is swollen above or below your cast or splint.
• Your cast is falling apart or rubs or irritates your skin.
• Pain or swelling continues to get worse or becomes severe.
• You have numbness, tingling, or coldness in your hand or your fingers look dark.
• You cannot move your fingers because of swelling or pain.

Distal radius fracture; Broken wrist

Franco VS, Kim HT. Wrist and forearm injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 43.

Kalb RL, Fowler GC. Fracture care. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 178.

Perez EA. Fractures of the shoulder, arm, and forearm. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 57.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.