Has your doctor just told you that you have had a colles’ fracture on the wrist?
This is one of the most common fractures in both kids and adults, especially the elderly I see in x-ray every day.
As usual I draw on my knowledge as a diagnostic radiographer and on the data available in medical studies, so that you can have more precise figures on healing time in particular.
Any questions or any experience to share, let’s meet in the comments section at the end of this article.
Summary: A Colles fracture, the broken piece of your wrist bone (radius) points backward while a Smith fracture the broken end of your bone points forward.
▶️What does a Colles’ fracture look like and is it the same as Smith fracture of the wrist?
When you have had a Colles’ fracture your doctor will describe it into 5 aspects.
🔴A distal radius fracture with dorsal comminution
🔴Dorsal angulation.
🔴Dorsal displacement or non-displaced.
🔴Radial shortening.
🔴An associated ulnar styloid fracture
This description is often used when describing the type of colles’ fractures displacement. Usually, the bone fragments are far apart as a result healing can take longer.
A colles’ fracture is often caused by falling on an outstretched hand with the wrist in dorsiflexion causing tension on the volar aspect of the wrist.
While a Smith’s fracture is a volar displacement fracture where the fragment of the radius that has broken off projects towards the palm side of the hand,
Images of a dorsiflexion of a wrist fracture showing a colles’ fracture and a volar displacement showing a smith fracture
Image from: ncbi.nlm.gov. books
▶️Why more in elderly adults and in children?
This kind of fracture occurs in all people of all ages, but more often I have seen more x-rays for broken wrists from the elderly women and children.
Why does it happen?
These fractures tend to result in displacement in elderly people because at the age of 60 and over your bones are likely to be osteoporotic.
People of all ages do get a Colles’ fracture not only from falls but also from trauma sustained from a car crash, skiing, skating, horseback riding, bike riding or contact sports.
▶️How do you know you have broken your wrist?
When you have had a fall on an outstretched hand or injured it in any way, you will straight away have obvious deformity on your wrist most of the time.
Here are some of the symptoms I see with patients who come for x-ray.
♦️Pain when trying to bend the wrist.
♦️Tenderness when trying to touch and position a patient for x-ray.
♦️Swelling around the injured wrist.
♦️Bruising which is obvious.
♦️Deformity of the wrist is the obvious sign I see when patients come to x-ray
The image below shows a wrist colles’ fracture deformity and hanging in an unnatural position.
Image credit: sylvain letuffe,2025 Feb
▶️How serious is a Colles’ fracture?
I usually hear patients ask this question when they come for x-ray, the truth is a colles’ fracture can be a very serious injury.
It is advisable for you to seek medical treatment if you think you have fractured your wrist.
Here are some of the possible complications after and before treatment that can rise.
🔵Wrist stiffness is most common especially when a cast has been taken off.
🔵Too much pressure around the muscles can cause compartment syndrome which can be very painful.
🔵Your wrist may feel numb, weak and painful caused by compression of the nerves called carpal tunnel syndrome.
🔵When you do not get immediate treatment, malunion will occur.
🔵You may experience reflex sympathetic dystrophy which may cause burning pain in your arms, legs, hands or feet.
🔵Osteoarthritis might develop in your wrist causing your pain and swelling.
▶️How is a colles’ fracture diagnosed?
When you have had a colles’ wrist fracture you will have to seek urgent medical attention because the pain can be severe and throbbing
Your doctor will examine your injury, by checking your pulse and the sensitivity and motor skills in your fingers and wrist.
An x-ray will be requested to help diagnose your fracture.
An MRI or CT may only be requested for soft tissue, muscle, ligaments and tendon assessment plus treatment plan.
▶️What is the usual treatment for colles’ fractures?
There are two types of management or treatment for wrist colles’ fractures depending on the type of fracture you have had.
1️⃣Conservative management
2️⃣Surgical management which is rare.
Conservative management:
🔵 Cast immobilisation
In most cases a colles’ fracture needs to be reduced using hand manoeuvres to realign the bones correctly. This will depend on how the bone is displaced.
This is followed by cast immobilisation and possibly rehabilitation whether you have had cast or surgical.
Most patients I see after a cast brace or splint has been applied to hold the broken pieces in place.
They will come for x-ray for a post check image to see if the fracture is well aligned.
Post x-ray images showing a colles’ fracture in a cast well aligned
Usually, the cast will be kept on for 6 weeks, then you will come back for a post check x-ray and an assessment to see how the fracture is healing.
Several studies have looked at analysts of instability in colles’ distal wrist fractures being treated conservatively.
One of the most significant predictors of instability was increasing age. I have seen more elderly people tend to displace because they have osteoporotic bones.
There is good evidence that inadequate anatomic reduction of distal radius fractures in a young patient population corresponds to poor functional outcomes. This, however, does not necessarily translate in an elderly population (Blakeney, 2010)
Radiography images showing correlation measures of outcome in elderly patients with distal colles’ radius fracture (Blakeney, 2019)
Caution! When an elderly patient is treated for colles’ wrist fractures usually doctors take a few things in account rather than the fracture pattern.
♦️One needs to consider medical history.
♦️Operative risk, as well as functional demands.
🔵 fracture surgery option
Usually if your bones are too out of place the orthopaedic surgeon will manipulate the bones into the correct position.
Then uses one or two of the following to align the fracture before a cast is applied.
Plates, screws, metal pins or an external fixator that is usually outside of your bone.
Image and x-ray image showing an external fixator (Blakeney, 2019)
A randomized controlled trial compared external fixation with conservative management for re-displaced fractures in 43 patients aged over 55 years.
25 Patients in the external fixation group showed a significantly better anatomical result.
Whatever treatment option your doctor decides to use, you will be referred to an orthopaedist who specialises in wrist fractures until you recover fully.
▶️How long can I keep the splint or cast on?
The medical team treating you should have given you personalised information on how long the cast or splint will stay on, I have seen patients come for a post check x-ray after 6 weeks.
Usually, a follow up x-ray is taken after 3 to 4 weeks to see how the fracture is progressing, and this helps your doctors to decide when to stop immobilisation.
When you have a splint, you can always remove it when you are having a shower.
Make sure you wear the splint and sling correctly to help reduce the discomfort.
Here is an image showing the right way of wearing a sling.
Physiotherapy is often prescribed after a colles’ fracture especially for adults. Most after the immobilisation period.
Some people do decide not to have any physiotherapy and prefer to do exercises on their own at home.
▶️Why am I so tired with a broken collas’ wrist?
When you have fractured any bone in your body it is normal to feel tired, fatigue and sometimes have mood changes.
I have seen some people claim to find their balance poor after a wrist fracture with no strength and feeling stiffness in the wrist.
While your wrist is healing in the cast your muscles become weak, and your joints can become stiff.
When a bone is fractured, the healing process normally begins with inflammation, with an immediate accumulation of blood cells adjacent to the injury site forming a haematoma, which acts as a template for callus formation.
During this process the cells releases inflammatory mediators and increase the permeability of blood capillaries
This initial inflammatory reaction generally will resolve within 7 days, and you will feel other symptoms such as
🟡Pain
🟡Heat
🟡Redness
🟡Swelling and loss of function
According to scientific studies all these symptoms may not be confined to the site of injury and not connected to the healing process itself.
Nicoll,2019
Because of this you may find yourself tired, having sleeping disturbances, depression and sickness behaviour even without you taking any anti-inflammatory medication to help.
You just have to be patient and get enough rest to allow the healing process to take place.
▶️How long does it take to get full range of motion after a broken wrist?
The total healing time for a colles’ fracture is a few months, often 2 to 3 months. By healing I mean how long it will probably be possible to use your wrist like before.
Here are some of the usual delays I see in patients after a colles’ fracture whether operated on or not.
| Phase | Usual Healing time |
| Much less pain | A few days to a few weeks |
| Swelling and bruising | A few days to a few weeks |
| Cast off | 6 weeks or more |
| Bone consolidation | 6 weeks to 8 weeks much less in children |
| Using your arm gradually for daily activities | A few weeks to a few months |
| Using your arm to curry a bag | 2 to 4 months or more |
| Back to work | Will depend on what kind of work you do, 6 to 8 weeks or more |
| You can use your wrist to do all the activities | 3 to 8 months |
All healing and recovery are shortened in children and adolescents.
We have come to the end of this article, all references at the end of this article.
Wishing you a quick recovery!🙋
📚Source:
Blakeney WG. Stabilization and treatment of Colles’ fractures in elderly patients. Clin Interv Aging. 2010 Nov 18; 5:337-44. doi: 10.2147/CIA.S10042. PMID: 21228899; PMCID: PMC3010169.
Corsino CB, Reeves RA, Sieg RN. Distal Radius Fractures. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-
Nicoll R. Sickness behavior may follow fracture as well as infection. Brain Behav Immun Health. 2019 Nov 14;1:100002. doi: 10.1016/j.bbih.2019.100002. PMID: 38377428; PMCID: PMC8474528.
Summers K, Mabrouk A, Fowles SM. Colles Fracture. [Updated 2023 July 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-
By sylvain letuffe – Own work, CC0, https://commons.wikimedia.org/w/index.php?curid=15800949