A colles fracture typically occurs subsequent to a fall from the standing position onto an outstretched hand with an extended wrist. Dorsal displacement of the distal radius may result in a deformed wrist in the shape of a dinner fork. The diagnosis is confirmed with plain radiography, including anterior-posterior, lateral, and oblique views. In addition to regular fracture care, it is important to assess the radial pulse and document the quality of median nerve function (e.g., sensation in the thumb and index fingers, extension of the thumb) before and after reduction. With a nondisplaced extraarticular fracture, cast the arm in a neutral position. Emergent orthopedic referral is required for patients with an open fracture, compartment syndrome, or neurovascular compromise. Displaced fractures with neurovascular compromise require immediate closed reduction. Some complications include acute carpal tunnel syndrome, malunion (which can lead to loss of motion and pain), posttraumatic osteoarthritis, and tendinous attrition (which can lead to tendon rupture).
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