Colles Wrist Fracture, No 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 near the wrist, it's called a Colles fracture. Colles fractures often occur when a child puts an arm forward to break a fall. These fractures can also occur during contact sports.

To hold the bone in place while it heals, the arm is put into a splint or cast. Splinting may be done until swelling is reduced before a cast is applied. A cast is usually left on for 4 to 8 weeks. If the cast becomes loose during that time, it may be replaced with a new cast. The injury usually heals with no problems. Once the cast is removed, stiffness in the wrist may continue for up to a year.

Home care

  • Give your child pain medicines as directed by the healthcare provider. Don't give your child aspirin unless told to by a healthcare provider.

  • Follow the healthcare provider's instructions about how much your child should use the affected arm.

  • Keep the child's hand and wrist elevated to reduce pain and swelling. This is most important during the first 48 hours after injury. As often as possible, have the child sit or lie down and place pillows under the child’s wrist until it's raised above the level of the heart. For babies and 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.

  • Apply a cold pack to the injury to help control swelling. You can make an cold pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the ice directly on the skin, because this can cause damage. You can place a cold pack directly over a splint or cast.

  • Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue 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 don't force your child to use the ice. 

  • Care for the splint or cast as you’ve been instructed. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.

  • Keep the splint or cast completely dry at all times. The splint or cast should be covered with a plastic bag and kept out of the water when your child bathes. Close the top end of the bag with tape or rubber bands.

  • Encourage your child to wiggle or exercise the fingers of the affected hand often.

Follow-up care

Follow up with the child's healthcare provider or as advised. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. If you were referred to a specialist, make that appointment promptly.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.

When to seek medical advice

Call your child's healthcare provider right away for any of the following:

  • Wet or soft splint or cast

  • Splint or cast is too tight. Loosen a splint before going for help.

  • Increasing swelling or pain after a cast or splint is put on the hand of the injured wrist. Babies who can't yet talk may show pain with crying that can't be soothed.

  • Fingers on the injured hand are cold, blue, numb, burning, or tingly 

  • Child can’t move the fingers of the affected hand

  • Redness, warmth, swelling, or drainage from the wound, or foul odor from a cast or splint

  • In babies, fussiness or crying that can't be soothed

  • Fever (see Fever and children, below)

  • Chills

Call 911

Call 911 if your child has:

  • Trouble breathing

  • Confusion

  • Trouble awakening or is very drowsy

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Baby under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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