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 is 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 proper 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:

  • Give your child pain medicines as directed by the healthcare provider. Do not 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 your 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 your child sit or lie down and place pillows under his or her wrist until it is raised above the level of the heart. 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 do not move near the face of the baby or toddler. Never leave the child unsupervised.

  • 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. Do not place the ice directly on the skin, as this can cause damage. You can place a cold pack directly over the cast.

  • 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. 

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

  • Always keep the cast completely dry. The 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 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

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. They 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 get medical care

Call your child's healthcare provider right away if any of these occur:

  • Wet or soft cast

  • Cast is too tight or too loose

  • Increasing swelling or pain after the cast is put on (babies 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 fluid leaking from the wound, or bad smell from the cast

  • In babies, fussiness or crying that cannot be soothed

  • Fever (see Fever and children, below)

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

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4 or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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