The wrist is a modified ball-and-socket joint that is made up of three joints: the radiocarpal joint, ulnocarpal joint and distal radioulnar joint. The radiocarpal joint is where the radius (a forearm bone) meets the first row of wrist bones. A wrist fracture can happen to anyone and is a common injury. A fracture occurs when a bone is broken.
What is a silver fork fracture?
The most common fracture of the forearm involves the wrist: the distal radius fracture. Approximately 16% of all skeletal fractures are due to distal radial fractures. This fracture is also referred to as a Colles’ fracture, after Abraham Colles, the doctor who first described its appearance before the invention of the X-ray. He described the deformity of the fracture as the appearance of a dinner or silver fork.
A silver fork fracture typically occurs when you try to catch yourself as you fall on your outstretched hand. The radius breaks on the end and is pushed up and back, giving your hand and wrist the appearance similar to a fork.
Who is most at risk for a silver fork fracture?
While a wrist fracture can happen to anyone, those most likely to sustain a distal radius fracture are young adults and the elderly. Women are more likely to experience this type of fracture than men, especially if the woman has a history of osteoporosis.
In older patients, a silver fork fracture typically occurs due to a ground-level fall with the arm outstretched due to the person trying to catch themselves as they fall. In younger patients, this same fracture usually comes from a high-impact trauma due to contact sports or a fall from a taller height.
Signs of a silver fork fracture
The main presentation of the distal radius fracture is the silver fork deformity. However, there are other signs of a fracture, including:
- Wrist pain close to the thumb.
- Inability to grab objects.
- Swollen wrist.
- Bruising of the wrist.
- Numbness in the wrist.
- Tenderness of the wrist.
- History of a fall on an outstretched hand.
If you believe you may have a broken wrist, seek medical attention immediately. Delaying treatment can affect your recovery. Your wrist will be X-rayed, and the X-rays will be evaluated to determine the course of treatment for your fracture.
Treatment for a silver fork fracture
Treatment for your wrist fracture will depend on the severity of the fracture. If it is an uncomplicated break with no other issues, your treatment will likely be a hard cast for up to six weeks followed by a wearable splint for a period after for comfort and support. You may have X-rays during your recovery to make sure that healing is going as it should. After the removal of the hard cast, you will likely be recommended for physical therapy to help you build back proper strength and mobility in your wrist.
If the fracture can’t easily be treated with a cast, you may require surgery to help ensure that your wrist heals properly. Surgery occasionally calls for plates and screws to be installed in your wrist to help reestablish proper form for your wrist. After surgery, you will have a splint placed to help keep your wrist stable during initial healing. At your post-op check, you’ll then receive a removable wrist brace that you’ll wear for approximately four to six weeks. After surgery, physical therapy can help you regain wrist strength and function.
Physical therapy for a silver fork fracture
Once you are cleared by your orthopedic doctor, it will be advantageous to begin physical therapy. A physical therapist can work with you to help you relieve your wrist pain and focus on regaining strength and mobility.
The first step of your physical therapy will be to help you with any pain you are experiencing in your wrist. Even with a simple fracture in a cast, you may still experience pain or stiffness due your wrist having been immobilized during healing. Your physical therapist may use modalities such as ultrasound, electrical stimulation, heat or cold therapy, and manual therapy to help with pain and help improve circulation to boost continued healing. These modalities may be used at the wrist joint or also on your hand, forearm, elbow, or shoulder.
The next phase of physical therapy will focus on rebuilding your range of motion, dexterity and strength of the affected arm. Your physical therapist will instruct you in exercises you can complete both under their guidance in the clinic and at home to maximize the healing benefits you can get from physical therapy. It is important to follow all guidance of your physical therapist and keep them informed of any new or changing pain during your treatment.
As your wrist heals and improves, your physical therapist may up the intensity of your treatments to help continue your mobility and strength of your wrist.
Forever Fit Physical Therapy & Wellness can provide you with expert care for your silver fork fracture
Physical therapy can improve your recovery from a silver fork fracture. Our team at Forever Fit Physical Therapy & Wellness can guide you through an individualized treatment plan to improve your quality of life. Our licensed physical therapists are ready to help you take the first steps in ensuring that your wrist heals properly.
Contact our team today for more information or to schedule an initial appointment.