Give My Wrist a Break--And a New NameIf you say the name "Colles" (pronounced "call-eez"), most doctors automatically think "wrist fracture." Dr. Abraham Colles first described this type of fracture in 1814. A Colles fracture is a break at the end of the radius bone within 1.5 inches of the wrist joint. (The radius is one of two bones in the forearm that attaches to the wrist.)
After all these years, doctors still use the term "Colles fracture." However, this term describes a range of injuries. Often there is more damage than just the break in the bone. In more than one-third of all cases, there is injury to the joint surfaces or connecting ligaments, or damage to the small wrist bones. Today's medicine requires a better, more specific way to classify these types of injuries.
A better naming or classification system would help guide treatment. It would also give doctors a way to predict treatment results. If a fracture is not treated properly, serious problems may result. The bones may shorten. Joints may become stiff and painful. Arthritis may develop down the line.
Treatment for Colles fractures has changed over the years. Doctors now use an arthroscope to see inside the joint and decide when surgery is needed. Plaster casts and other means of immobilizing the wrist have been replaced by other methods. New methods keep the bones together while still allowing wrist movement.
Devices called external fixators use surgical pins to hold the bones in place during healing. Fixators have improved over the years to allow for wrist motion and prevent joint stiffness. However, these devices can lead to problems. Sometimes patients develop nerve or tendon damage, hand and finger stiffness, or even fractures of the fingers. A newer method of injecting a calcium-based glue into the joint is under trial. So far, studies show this to be just as good as using pins to fix the bones in place.
Treatment of Colles wrist fractures has advanced in the last 180 years. A more specific way of naming these fractures would allow doctors to compare different treatment methods for similar injuries. This would help doctors decide the best way to treat each type of fracture.
Jegan Krishnan, MBBS, FRACS, PhD. Distal Radius Fractures in Adults. In Orthopedics. February 2002. Vol. 25. No. 2. Pp. 175-180.
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