Radius Fracture

Injuries > Wrist > Radius Fracture

(Also known as a Colles' Fracture, Broken Wrist, Wrist Fracture, Fractured Radius, Distal Radius Fracture, Broken Radius)

What is a radius fracture?

A radius fracture is a relatively common condition characterized by a break in one of the long bones of the forearm known as the radius (figure 1).

The forearm comprises of 2 long bones known as the radius and ulna which are situated beside each other (figure 1). The radius bone lies on the thumb side of the forearm and forms joints with the ulna (near the elbow and wrist) and several small bones at the wrist (figure 1).

During certain activities such as a fall on the outstretched hand, stress is placed on the radius bone. When this stress is traumatic and beyond what the bone can withstand a break in the radius may occur. This condition is known as a radius fracture.

A radius fracture is common among the elderly, but can also occur in the younger patient. Often a fracture to the radius occurs in combination with fractures to other bones such as the ulnar or scaphoid.

Causes of a radius fracture

A radius fracture most commonly occurs due to a traumatic weight bearing force through the wrist such as a fall onto an outstretched hand. This may occur with any fall, but is particularly common in sports such as skateboarding or snowboarding (particularly in icy conditions) where a fall onto a hard surface is unforgiving.

Signs and symptoms of a radius fracture

Patients with this condition typically experience a sudden onset of sharp, intense wrist or forearm pain at the time of injury. This often causes the patient to cradle the affected arm so as to protect the wrist. Pain is usually felt on the thumb side of the wrist and forearm and can occasionally settle quickly leaving patients with an ache at the site of injury that is particularly prominent at night or first thing in the morning. Patients with a radius fracture may also experience swelling and pain on firmly touching the affected region of the bone. Pain may also increase during certain movements of the wrist, when gripping or during weight-bearing activity (such as pushing) through the affected wrist. In severe radius fractures (with bony displacement), an obvious deformity may be detected.

Diagnosis of a radius fracture

A thorough subjective and objective examination from a physiotherapist is essential to assist with diagnosis of a radius fracture. An X-ray is usually required to confirm diagnosis. Further investigations such as an MRI, CT scan or bone scan may be required, in some cases, to assist with diagnosis and assess the severity of injury.

Treatment for a radius fracture

Treatment for a fractured radius typically involves anatomical reduction (i.e. re-alignment of the fracture by careful manipulation under anesthetic) followed by immobilization in a plaster cast for 6 weeks. Evaluation of the fracture during this period with follow up X-rays is important to ensure the fracture is healing in an ideal position. Once healing is confirmed and the plaster cast has been removed, rehabilitation can begin as guided by the treating physiotherapist.

One of the most important components of rehabilitation following a radius fracture is that the patient rests sufficiently from any activity that increases their pain. Activities which place large amounts of stress through the radius should also be avoided particularly weight bearing or pushing activities. Rest from aggravating activities allows the healing process to take place in the absence of further damage. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms. This should take place over a period of weeks to months with direction from the treating physiotherapist.

Ignoring symptoms or adopting a 'no pain, no gain' attitude is likely to cause further damage and may slow healing or prevent healing of the radius fracture altogether.

Patients with a fractured radius should perform pain-free flexibility and strengthening exercises as part of their rehabilitation to ensure an optimal outcome. This is particularly important, as soft tissue flexibility and strength are quickly lost with plaster cast immobilization. The treating physiotherapist can advise which exercises are most appropriate for the patient and when they should be commenced.

Occasionally, surgical intervention may be indicated in patients with this condition. This is most common in severe radius fractures (with displacement) or in those cases that do not respond to conservative treatment. Surgery typically involves internal fixation (often with plates and screws) to stabilize the fracture.

Prognosis of a radius fracture

Patients with a fractured radius usually make a full recovery with appropriate management (whether surgical or conservative). Return to activity or sport can usually take place in weeks to months and should be guided by the treating physiotherapist and specialist. In patients with severe injuries involving damage to other bones, soft tissue, nerves or blood vessels, recovery time may be significantly prolonged.

Physiotherapy for a radius fracture

Physiotherapy treatment (particularly following removal of the plaster cast) is vital in all patients with this condition to hasten healing and ensure an optimal outcome. Treatment may comprise:

• soft tissue massage
• joint mobilization
• electrotherapy (e.g. ultrasound)
• taping or bracing
• exercises to improve strength and flexibility
• education
• activity modification
• a graduated return to activity plan

Other intervention for a radius fracture

Despite appropriate physiotherapy management, some patients with this condition do not improve adequately and may require other intervention. The treating physiotherapist or doctor can advise on the best course of management when this is the case. This may include further investigations such as X-rays, CT scan, MRI or bone scan, extended periods of plaster cast immobilization or referral to appropriate medical authorities who can advise on any intervention that may be appropriate to improve the fractured radius. Occasionally, patients may require surgery to stabilize the fracture and a bone graft to aid fracture healing.

Exercises for a radius fracture

The following exercises are commonly prescribed to patients with a fractured radius following confirmation that the fracture has healed, and, removal of the plaster cast. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms.

Elbow Bend to Straighten

Bend and straighten your elbow as far as possible pain-free (figure 2). Repeat 10 times provided there is no increase in symptoms.

Figure 2 – Elbow Bend to Straighten (left side)

Wrist Bends

Begin this exercise with your forearm supported by a table or bench and your wrist and fingers over the edge (figure 3). Slowly bend your wrist forwards and backwards until you feel a mild to moderate stretch pain-free. Repeat 10 times provided there is no increase in symptoms.

Figure 3 – Wrist Bends (right side)

Forearm Rotations

Begin this exercise with your elbow at your side and bent to 90 degrees (figure 4). Slowly rotate your palm up and down until you feel a mild to moderate stretch pain-free. Repeat 10 times provided there is no increase in symptoms.

Figure 4 – Forearm Rotations (right side)

Wrist Side Bends

Begin this exercise with your forearm supported by a table or bench and your wrist and fingers over the edge (figure 5). Slowly bend your wrist from side to side until you feel a mild to moderate stretch pain-free. Repeat 10 times provided there is no increase in symptoms.

Figure 5 – Wrist Side Bends (right side)

Tennis Ball Squeeze

Begin this exercise holding a tennis ball (figure 6). Squeeze the tennis ball as hard as possible and comfortable without pain. Hold for 5 seconds and repeat 10 times provided there is no increase in symptoms.

Figure 6 – Tennis Ball Squeeze (right hand)

Physiotherapy products for a radius fracture

Some of the most commonly recommended products by physiotherapists to hasten healing and speed recovery in patients with a radius fracture include:

1. Slings
2. Wrist Braces
3. Ice Packs and Heat Packs
4. Resistance Band (for strengthening exercises under physiotherapy guidance)

To purchase physiotherapy products for a radius fracture click on one of the above links or visit the PhysioAdvisor Shop.

Other Exercises

• View more Wrist Flexibility Exercises.
• View more Wrist Strengthening Exercises.

Find a Physio for a radius fracture

Find a Physiotherapist in your local area who can treat this condition.

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