Colles fracture is a complete fracture of the radius bone of the forearm which is close to the wrist resulting in upward direction so known as broken deformity. Colles fracture runs transversally above the wrist joint and gives wrist dinner fork deformity. Colles is named after the name of a surgeon which resulted from slip or fall of the hand. Colles fracture mainly occur when there is fall on the ground and hands hit the ground which results in fracture of wrist and further bruises of skin over it. As bone is supplied richly with blood vessels so when this condition arrives it is painful. Colles fracture is seen in all age groups but more common in elderly people and children. These fracture is common in menopausal females. Let’s discuss it in detail!
Colles fracture is the wrist fracture which runs above the wrist joint and displays the bone end more dorsally. Colles are seen in children as bones are soft so they can easily bend so fracture remains incomplete. In adults there are complete fractures. Colles fracture is linear transverse fracture of distal radius which is accompanied with damage to ulnar collateral ligament, when person falls on the ground wrist is at 40-90 degree in dorsiflexion position when the pressure overextend breaks the radius above wrist so the parts which are communicated are broken in multiple pieces. Osteoporosis and colles fracture has strong relation as when patients get colles fracture the investigation of osteoporosis is done.
CAUSES OF COLLE’S FRACTURE
- Colles fracture mainly occur with a fall on road with outstretched hand.
- Trauma on driving car, bike, and skiing accident.
- Osteoporosis (this weakens the bones and later in life there is breaking in bones).
SIGNS AND SYMPTOMS OF COLLE’S FRACTURE
- Wrist in seen in a different way
- Broken wrist shows symptoms of severe pain, numbness, and fingers get discolored
They are different forms of colles fracture which are further classified into 8 types which is further based on extra and intra articular nature of fracture which includes radius and ulna
- Type 1 transverse metaphyseal fracture
- Type 2 includes type1 with ulnar styloid fracture
- Type 3 involves the radiocarpal joint which includes barton and reverse barton and chauffeur fracture
- Type 4 includes type 3 with ulnar styloid fracture
- Type 5 transverse fracture with distal radioulnar joint
- Type 6 involves type5 with ulnar styloid fracture
- Type 7 comminuted fracture with radiocarpal and radioulnar joints
- Type 8 involves type 7 with an ulnar styloid process.
COMPLICATIONS OF COLLE’S FRACTURE
- Shortening of radius
- Stiffness in wrist and forearm
- Persistent translation of carpus
- Very rarely a complication like carpal tunnel syndrome (is caused due to pressure on the median nerve) is marrow tunnel which is surrounded by bones and ligaments. When the nerve is compressed there is numbness, tingling sensation, and weakness in the hand
- Ulnar and radial compression neuropathy
DIFFERENTIAL DIAGNOSIS OF COLLE’S FRACTURE
- Median nerve injury (carpal tunnel syndrome which is associated with pain, numbness, tingling sensation).
- TFCC (triangular fibrocartilage complex) injury is made of tough fibrous tissue and cartilage, acting as a cushion between the end of the ulna and small bones of the wrist.
- Ulnar styloid fracture.
- Compartment syndrome (excessive pressure builds up inside the enclosed muscle in the body). There are 5 P’s : pain, pallor, paresthesia (numbness), pulselessness (faint pulse), paralysis (weakness with muscles).
- DRUJ (distal radioulnar joint) instability.
DIAGNOSIS OF COLLE’S FRACTURE
- Plain radiograph
TREATMENT OF COLLE’S FRACTURE
Treatment for a colles fracture is to set back all the broken bones until they healed up. There are many methods to stabilize the fracture and allow bone to heal.
- When fracture occurs one must apply ice packs to wrist
- Surgery – If the bone is displaced and there are more than 2 fragments then surgery is done with close reduction, and then the doctor makes an incision to align the bones is called open reduction.
- Non surgical method – If bone is in a good position and has no displacement then cast or plaster is applied to heal the bone. The cast applied is kept for 6 weeks
- Plates and screws
- Metal pins, usually stainless steel
- Modalities such as –
- Heat wax – Is a pack of heat packs which is very beneficial in early stages to reduce pain and improve the venous return.
- Cryotherapy – Is an effective modality for edema as it helps to decrease the blood flow through vasoconstriction. This is used to control the pain using cryotherapy applied for 10-15 minutes.
- Exercise is very beneficial to restore the range of hands, wrist, shoulder. Exercise improves strength to the hand such as buttoning a shirt can be difficult after a colles fracture so exercise is important to maintain and improve strength to muscles.
- Physical therapy management – When a patient is presented to a physiotherapist with edema, pain, decreased motions, once colles have healed rehabilitation is done to restore the proper function and provide strength to wrist muscles. One of the primary focuses on rehabilitation is to limit the pain and amount of oedema in the wrist and hand region.
- The next phase of rehabilitation is to continue with increasing wrist ROM and exercise of ROM can be performed by –
- Wrist flexion / extension
- Pronation and supination
- Radial and ulnar deviation
AYURVEDIC MANAGEMENT OF COLLE’S FRACTURE
Fractures are the result of fall when a person ‘s bones are weak due to osteoporosis or brittle bone. In ayurveda it is explained fracture as bhagna which means continuous break in bone which results in lack of motion. A break in bone can be due to dislocation (Sandhi mukta) with fractures called kanda bhagna (long bones). The term bhagna covers all body disruption from high range fractures to low hairline fractures.
ETIOLOGY OF COLLE’S FRACTURE
- Road side accidents
CLINICAL FEATURES OF COLLE’S FRACTURE
- Massive swelling
- Agonizing type of pain
- Loss of movements or restricted movements
- Complete immobility
HERBAL REMEDIES FOR COLLE’S FRACTURE BY PLANET AYURVEDA
Planet ayurveda provides the best combination of herbal remedies such as lakshadi guggul, dashmool capsule for treatment for bhagna. These herbal remedies are prepared using best quality herbs under strict principles of ayurveda. All these products are 100% pure, natural and are free from any preservatives. These are safe to use as they are free from side effects.
- Lakshadi Guggul
- Cissus Power
- Ashwagandhadi Ghrit
- Bone Support
- Dashmoola Capsules
1. Lakshadi Guggul
Lakshadi guggul is a classical preparation in the form of tablets which is formulated by planet Ayurveda for effective under strict surveillance of M.D experts. Lakshadi guggul is very much effective drug which contains Laksha (Laccifer lacca), Arjuna (Terminalia arjuna), Nagabala (Grewia populifolia), Ashwagandha (Withania somnifera), Guggul (Commiphora mukul). Due to any type of trauma there is aggravation of vata dosha which results in pain and swelling. This formulation has arjuna which enhances the circulation. Lakshadi guggul soothes the ligaments and enhances bone density.
Dosage: 1-2 tablets twice daily with lukewarm water.
2. Cissus Power
Cissus power is a very powerful formulation in capsule form formulated by planet Ayurveda consisting of the single herb Hadjod (Cissus quadrangularis). This herb is known for its healing process of broken bones. Cissus power has an exclusive effect on the entire skeleton system. This herb has qualities like it is light to digest, has sweet taste, has hot potency and it balances vata and kapha dosha.
Dosage: 1-2 capsules twice daily with plain water.
3. Ashwagandhadi Ghrit
Ashwagandha ghrita is a ghrita preparation which is really effective and uplifts the general weakness in the presence of pain. This ghrit is classical ayurveda product formulated by planet ayurveda under strict surveillance consists of Ashwagandha (Withania somnifera), Bhibhitaki (Terminalia bellirica), Go ghrita (cow ghee), Go dugdha (cow milk), water. Ashwagandha ghrita helps to gain weight and improves the process of healing. Cow ghee and Cow milk pacifie the vata dosha. Ashwagandha ghrita nourishes tissues, joints and nerves.
Dosage: 3-6 gms mixed with mishri.
4. Bone Support
Bone support is a great combination of herbs in the form of capsules which is formulated by planet ayurveda containing many herbs such as Shudh laksha (Laccifer lacca), Suhanjana beej (Moringa oleifera), Arjuna (Terminalia arjuna), Mukta (Compound of pearl calcium). This capsule helps in relieving symptoms like pricking pain and swelling. Bone support has arjuna which improves the circulation, it has mukta which enhances the calcium levels in the body.
Dosage: 1 capsule twice daily after meals with plain water.
5. Dashmoola Capsules
Dashmool capsules has group of herbs which are effective in pacifying the doshas and is well formulated by planet ayurveda using ingredients Bilwa (Aegle marmelos), Shyonak (Oroxylum indicum), Gokshur (Tribulus terrestris), Brihati (Solanum indicum), Shalparni (Desmodium gangeticum) and many more. Dashmool capsules pacify the vata dosha which subside the pain. Dashmool is a great antibiotic, analgesics, useful in treating bronchitis, asthma condition, it reduces chronic autoimmune inflammatory disease like RA, urinary infections, and ailments in liver disease.
Dosage: 1-2 capsules twice daily with plain water after meals.
Colles fracture is wrist fracture which runs above the wrist joint and displays bone end dorsally. In ayurveda, fracture is described as bhagna which occurs mainly due to aggravation of vata dosha. The main cause of colles fracture is by falling on the ground with extended hand forwards. Further we discussed ayurveda and herbal remedies by Planet Ayurveda that is a fracture healing pack in detail which provides much effective support to patients.