The wrist joint is a complex structure where the two forearm bones, the radius and the ulna, meet the eight small carpal bones of the hand. A wrist fracture occurs when any of these bones break, which is a common injury across all age groups. The most frequently encountered type of break is the distal radius fracture, specifically known as a Colles fracture. This injury involves a break in the larger of the two forearm bones at the point closest to the hand.
Identifying the Most Common Wrist Fracture
The distal radius is the thickened end of the radius bone that forms the primary weight-bearing surface of the wrist joint. A fracture in this area is common, accounting for up to 20% of all fractures in the adult population. The Colles fracture is a specific type of distal radius break defined by the broken fragment being displaced backward, or dorsally.
This dorsal displacement creates the noticeable physical sign of the injury. The wrist takes on a characteristic profile often described as a “dinner fork deformity,” caused by the bone fragment shifting upward and backward. A Colles fracture is further classified as an extra-articular injury, meaning the fracture line does not enter the main joint surface of the wrist.
Mechanisms of Injury
The vast majority of distal radius fractures result from a scenario known as a Fall Onto an Outstretched Hand (FOOSH). When a person falls forward, they instinctively extend their arm to brace for impact, forcing the wrist into an extreme backward-bending position. The resulting axial and bending forces overload the distal radius, causing it to fail.
The likelihood of this injury is highest in two distinct demographic groups. Younger individuals tend to sustain this fracture from high-energy trauma, such as sports injuries, requiring a significant amount of force to cause a break.
In contrast, older adults are highly susceptible to this fracture from low-energy incidents, such as a simple fall from a standing height. This increased fragility is strongly linked to osteoporosis, a condition that causes a decrease in bone mineral density. For women, the incidence rate often peaks in the perimenopausal age group due to hormonal changes.
Immediate Symptoms and Diagnosis
The immediate signs of a distal radius fracture begin with intense, sharp pain at the moment of impact. Significant swelling and bruising around the wrist joint develop rapidly. In more severe cases, the visual deformity described as the “dinner fork” shape may be apparent, confirming that the bone fragments are significantly out of place.
Patients may also experience numbness or tingling in the fingers, which can indicate potential compression of the median nerve. Seeking immediate medical attention is necessary, especially if there is severe pain or a loss of sensation. Diagnosis is confirmed through a physical examination, followed by X-rays, which are the standard for initial assessment.
Orthopedic specialists use X-rays to obtain multiple views, including anteroposterior and lateral projections, to precisely determine the fracture pattern. These images clarify the extent of bone displacement, joint surface involvement, and any associated breaks, guiding the decision-making process for treatment.
Treatment Pathways and Recovery
Treatment for a distal radius fracture is determined by the severity of the break, focusing on the degree of displacement and fracture stability. For fractures that are stable and not significantly displaced, the non-surgical pathway is chosen. This involves a closed reduction, where the physician manually realigns the bone fragments without an incision, followed by immobilization in a cast or splint for approximately six weeks.
Unstable or severely displaced fractures, particularly those that involve the joint surface, typically require surgical intervention. The most common procedure is Open Reduction and Internal Fixation (ORIF), where an incision is made to directly realign the bone fragments. The aligned pieces are then stabilized using internal fixation hardware, most often a plate and screws.
Following immobilization, physical therapy becomes a central component of recovery. The therapy focuses on regaining strength and restoring the full range of motion often lost due to stiffness. While the bone itself may heal in six to eight weeks, functional recovery often takes three to six months, with minor improvements potentially continuing for up to two years.