Colles Wrist Fracture, Reduction (Child)
The wrist has many bones. They allow the wrist to move in many different directions. The radius is the long bone that connects the thumb to the elbow. If the radius breaks (fractures) near the wrist, it's called a Colles fracture. This kind of fracture is common in children. A Colles fracture can occur when a child puts a hand forward trying to break a fall. It may also happen during sports.
A Colles fracture causes swelling, soreness, pain, and bruising. The wrist may be bent at an odd angle. The child may not want to move the wrist or fingers for fear of pain.
The broken bone may need to be adjusted back into correct alignment. This procedure is called reduction. For more severe fractures, surgery may be needed. The surgery would be done by an orthopedic surgeon. This is a surgeon who treats bone, muscle, joint, and tendon problems.
To hold the bone in place while it heals, a cast is often placed on the arm. The cast usually stays in place for about 6 to 8 weeks. After the cast is removed, the child can return to normal activities. Stiffness will gradually decrease in a few months. Full recovery may take up to a year.
Home care
Follow these guidelines when caring for your child at home:
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Give your child pain medicines as directed by the doctor. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.
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Follow the doctor's directions about how much your child should use the affected arm.
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Keep your child's hand and wrist elevated to reduce pain and swelling. For babies or toddlers, lay the child down and place pillows under the hand until the injury is raised above the level of the heart. Be sure that the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.
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Put a cold pack on the injury to help control swelling. You can make a cold pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, make sure that the cast doesn’t get wet. Don't place the ice directly on the skin, as this can cause damage. You can place a cold pack directly over the cast.
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Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue to do this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But if your child objects, don't force your child to use the ice.
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Care for the cast as you’ve been directed. Don’t put any powders or lotions inside the cast. Keep your child from sticking objects into the cast.
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Always keep the cast completely dry. Have your child bathe with their cast or splint out of the water. Protect it with 2 layers of plastic, such as 2 plastic bags. Close the top end of the bag with tape or rubber bands.
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Encourage your child to wiggle or exercise the fingers of the affected hand often.
Follow-up care
Follow up with the child's doctor as advised. Your child may need follow-up X-rays to see how the bone is healing. If your child was referred to a specialist, make that appointment soon.
Special note to parents
Doctors are trained to recognize injuries like this in young children as a sign of possible abuse. Several doctors may ask questions about how your child was injured. They must, by law, ask you these questions. This is done for the protection of the child. Please try to be patient and not take offense.
When to contact your child's doctor
Contact your child's doctor right away if:
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The cast is wet or soft.
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The cast is too tight or too loose.
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Your child has increasing swelling or pain after the cast is put on. Babies may show pain with crying that can't be soothed.
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The fingers on the injured hand are cold, blue, numb, burning, or tingly.
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Your child can’t move the fingers of the affected hand.
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Your child has a fever with redness, warmth, swelling, or fluid leaking from the wound, or bad smell from the cast.
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Your baby has fussiness or crying that can't be soothed.
Call 911
Call 911 if:
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Your child has trouble breathing.
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Your child shows confusion.
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Your child has trouble waking up or is very drowsy.
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Your child faints or loses consciousness.
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Your child has a rapid heart rate.
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Your child has a seizure.
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Your child has a stiff neck.