Colles Fracture vs Scaphoid Fracture

Wrist pain after a fall or another traumatic event can make it challenging for you to go about your normal activities. Instead of hoping your injury heals on its own, it’s wise to visit an orthopedic doctor for further evaluation. This move is especially important if your injury is a fracture, which is more serious than a typical sprain or strain. Seeking the appropriate medical attention optimizes your recovery timeline and ensures you get the proper diagnosis.

Here at The Hand and Wrist Institute, we’re going to discuss two common types of wrist fractures your doctor may diagnose: Colles and scaphoid. Read on to discover the importance of distinguishing between Colles and scaphoid fractures and the treatment options for each.

What Is a Colles Fracture?

A Colles fracture is a type of broken wrist in which an impact to your hand transfers energy to your radius (arm bone). The force causes the dorsal end of your radius (the part near your wrist) to break. The broken bone tilts upward and away from the center of the body, making it a type of distal fracture with dorsal angulation. Colles fractures are serious, painful injuries that require immediate medical attention.

What Is a Scaphoid Fracture?

A scaphoid fracture is a type of broken wrist in which you break the small bone near the base of your thumb. This bone, the scaphoid bone, is one of the carpal bones that make up your wrist. Scaphoid fractures may involve you breaking one or more of the three parts of this bone. The three parts are:

• Distal pole: The distal pole is the end of your scaphoid closest to your hand and fingers. It points away from your body.
• Waist of the scaphoid: As the middle part of your scaphoid, the waist is the most common location of these types of fractures.
• Proximal pole: The proximal pole is opposite of the distal pole, as it’s the end closest to your forearm and points toward your body.

Additionally, a scaphoid fracture can be either displaced or nondisplaced. A displaced scaphoid fracture occurs when the pieces of your bone move enough to create a gap around the break. A nondisplaced scaphoid fracture is less serious, as the pieces don’t move far enough during the break to fall out of alignment.

Causes: Colles vs. Scaphoid Fracture

Colles and scaphoid fractures may occur if your wrist experiences any type of trauma. They’re particularly common after a patient tries to break a fall with an outstretched hand, though other causes include car accidents or accidents related to skating, skiing, horseback riding, bike riding, or contact sports.

Anyone can sustain either type of fracture, but Colles fractures are most common in women aged 60 and older with osteoporosis. This condition weakens your bones and can increase a patient’s risk of any type of fracture. Scaphoid fractures tend to be more common in teens and young adults under 30.

Symptoms: Colles vs. Scaphoid Fracture

The symptoms of Colles and scaphoid fractures are similar. Aside from intense pain at the time of the break, you might notice other signs like bruising, swelling, and a decreased range of motion. Your wrist might also be tender to the touch and have a deformity or bump that’s not usually there. The pain from a scaphoid fracture usually occurs closer to the thumb, while the pain from a Colles fracture might be more persistent near your wrist. Note symptoms can present themselves differently in each patient, so be sure to seek medical attention right away.

Diagnosis: Colles vs. Scaphoid Fracture

If you believe you have a broken wrist, you’ll want to go right to the emergency room. The health care team can administer the appropriate tests and provide temporary treatment until you’re able to see an orthopedic doctor to get surgery. Doctors will usually conduct a physical exam, ask about your symptoms and the accident that caused the injury, and order imaging tests to confirm their diagnosis.

An X-ray can reveal if you have a Colles or scaphoid fracture and provide insight into the severity of the injury. A doctor might order an MRI to see the surrounding muscles and connective tissue and determine whether they also sustained damage. If you need surgery, a CT scan helps provide the surgeon with a more complete picture of your bones and the surrounding areas. MRIs and CT scans are also useful for detecting occult scaphoid fractures that don’t show up well or at all on X-rays.

Treatment: Colles vs. Scaphoid Fracture

Colles and scaphoid fractures require medical treatment, as serious complications might arise if you try to let them heal on their own. If your bones aren’t too out of place, your doctor might rely on setting alone to move the bones back into their natural positions. This method involves the patient wearing a cast, brace, or splint for a specified period. If you have a scaphoid fracture, your doctor might use a nonsurgical method called a closed reduction to physically manipulate your body on the outside to reposition the broken bones inside.

More serious Colles and scaphoid fractures call for surgical intervention. If you have a Colles fracture, an orthopedic surgeon can use metal pins, plates, screws, or an external fixator to reposition your bones. Internal fixations are also surgical solutions for scaphoid fractures, with pins and wires being ideal for fastening particularly small bones. Another surgical solution for a scaphoid fracture is a bone graft. Regardless of which surgery you undergo, you’ll have to wear a cast for a specified period afterward and may take over-the-counter anti-inflammatories to manage pain. Your doctor may also recommend physical therapy to facilitate rehabilitation.

While Colles and scaphoid fractures have similar causes and symptoms, they require different treatment approaches. Schedule an appointment with The Hand and Wrist Institute today to receive an accurate diagnosis. After our orthopedic doctors evaluate you, we can recommend the appropriate treatment to ensure the best recovery possible. Patients in Dallas, Southlake, and beyond trust our team to reduce their pain and improve their overall quality of life.

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Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.