Further information If you require any further information after reading this leaflet, please contact: Warwick Hospital Physiotherapy Department Tel: 01926 608068 Stratford Hospital Physiotherapy Department Tel: 01789 205831 ext 5229 As a key provider of acute healthcare and as an employer, the Trust has a statutory obligation to promote and respect equality and human rights. This is set out in various pieces of legislation including: Race Relations (Amendment) Act 2000, Disability Discrimination Act (2005), Sex Discrimination Act (1975) and the Age Discrimination Act (2006) Our information for patients can also be made available in other languages, Braille, audio tape, disc or in large print. PALS We offer a Patient Advice Liaison Service (PALS). This is a confidential service for families to help with any questions or concerns about local health services. You can contact the service by the direct telephone line on 01926 600 054 or using the phone links which are available in both hospitals or calling in at the office located in the main entrance at Warwick Hospital. SWH00516 Revision no.2: Date: March 2011 Revision Date march 2013 Author: Outpatient Physiotherapy Team Leader PHYSIOTHERAPY DEPARTMENT Rehabilitation Advice Following Wrist (Colles) Fracture What is a Colles fracture? A broken wrist is common following a fall on an outstretched hand. A ‘Colles’ fracture is a fracture of the radius bone of the forearm, just above the wrist. Symptoms include a great deal of wrist pain, a "dinner fork" deformity, wrist swelling and an inability to use the wrist and hand. Exercises Continued: The Queen’s wave: Rest your elbow on a table with the hand held up at face height. Support your forearm by holding with your other hand. Keep your forearm still whilst moving your hand from side to side to perform the ‘Queen’s wave’. Prayer: With your forearms resting on a table, push palms together to perform the ‘prayer’ position. Hold for 10 seconds. How are Colles fractures managed? Most wrist fractures are managed in a light plaster cast. Some fractures require manipulation under anaesthetic before the plaster is applied. This ensures the best alignment of the bones for healing. Some complex fractures may require surgical repair to realign the bones. This may mean a plate and screws fitted to the bone internally or an external fixator. An external fixator is a series of plates and screws forming a framework to hold the bones together from the outside of the forearm 1 Getting your change in the shop: Keep your elbow bent and tucked into your side. Turn your hand over so the palm faces the ceiling (ensure elbow is kept still) and then twist wrist so palm faces the floor. Repeat 10 times Physiotherapy exercises: perform 10 repetitions of each exercise regularly throughout the day How long is the plaster/external fixator worn? A wrist fracture requires 4-8 weeks of protection to allow the bones to unite and the soft tissues to heal. Move your thumb to touch the tip of each finger. Once the plaster has been removed it is important to exercise the wrist and finger joints regularly to reduce joint discomfort and restore movements and strength. What symptoms could I experience when my plaster /external fixator is removed? Curl fingers round to make a fist and then fully straighten. Place your hand on a table with your hand relaxed over the edge of the table. Move your wrist up and down as far as you can. You can also use your other hand to give a little stretch. It is normal for the wrist to feel uncomfortable, achy and stiff after the plaster has been removed. The following symptoms are common • • • • • • • • • 2 5 Discomfort Altered shape of the wrist Swelling Stiffness Weakness Tingling, pins & needles, numbness Dry skin Dark hairs Discoloration How long before I can return to work? What can I do to help Myself? This will depend on the type of work you do and your consultant or physiotherapist will advise you. • Research has shown that taking regular pain relief helps patients to perform more effective physiotherapy exercises. This helps patients to get better quicker. • When resting, keep your arm elevated on pillows to reduce the swelling. • Hot and cold contrast water baths are useful to reduce swelling and discomfort. Fill one bowl with water as hot as you are able to tolerate and another with ice cold water. Place hand in cold water for 2 minutes and then immediately place into the hot water for 2 minutes. Repeat this procedure 3 times ending in cold water. • Soak your hand in warm, soapy water. Rub the skin gently and pat dry. Massage baby oil or moisturising cream into the skin. Caution Do not attempt heavy work for at least 6 weeks after your plaster/external fixator is removed or until advised by your consultant or physiotherapist. Will I need physiotherapy? Your consultant will advise you if you need physiotherapy. This depends on the severity of your injury and not everybody needs individual physiotherapy. Most patients make a full recovery by following the exercises and recommendations within this booklet. Exercise Exercise is a very important part of your rehabilitation. The discomfort in your wrist will reduce with exercise but your wrist is likely to ache until your wrist is fully mobile. Perform exercises slowly and gently to begin with. Should your symptoms worsen significantly please contact the Physiotherapy Department or your GP. 4 3