Fractures (Colles and Scaphoid)
What is it?
Colles fracture:
- This is a break in the radius (one of the bones of the forearm) near the wrist.
- It usually occurs after a fall onto an outstretched hand.
- It is common among those with osteoporosis due to decreased bone density.
- It is also common among the younger population often due to high impact trauma e.g. contact sports, skiing, horse riding.
Scaphoid fracture:
- This is a break of the scaphoid (a small bone in the wrist located near the thumb).
- It can occur due to trauma such as falling onto an outstretched hand or a direct blow to the area.
- Stress fractures can occasionally occur in the scaphoid as well- this is more commonly seen in high level athletes e.g. gymnasts and shot-putters.
Typical Symptoms/features:
Colles fracture:
- Pain at the wrist following trauma.
- Deformity of the wrist.
- Pain with movements.
- Once fracture has healed:
- may have stiffness and reduced range of movement of the wrist.
- Loss of strength e.g. picking up kettle, turning keys.
- Pain when weight-bearing through the wrist.
Scaphoid fracture:
- Specific pain over the scaphoid near the base of the thumb.
- May have swelling or bruising.
Imaging & Management:
-
Most Colles fractures will be picked up through A+E by an X-ray. Initial management generally includes plaster casting or surgical fixation depending on the level of displacement.
- Future X-rays may be repeated in fracture clinic to monitor healing.
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Scaphoid fractures are often not identified on X-ray right away after trauma.
- If a scaphoid fracture is suspected, further imaging may be indicated such as CT or MRI.
- Orthopaedic management generally includes immobilisation and/or surgery.
Physiotherapy Management.
- Can be commenced once cast is removed or when cleared by orthopaedics.
- To include range of movement and gradual strengthening programme.
