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A displaced fracture should be reduced under appropriate anaesthesia such as:
Disimpaction is achieved by pulling the hand distally and hyperextending the wrist. Once the fracture has been reduced, the wrist is manipulated into a position of palmar flexion, ulnar deviation and pronation.
The patient is given a sling with instructions to actively exercise the fingers, elbow and shoulder.
The fracture should be inspected the following day to check that the plaster is not too tight. A further appointment should be made in 7-10 days. Re-displacement is not uncommon and requires re-reduction.
The fracture should have united by about 6 weeks.
Undisplaced or minimally displaced fractures may be treated directly with a Colles' backslab.
Severely comminuted and unstable fractures may require external fixation. Designs such as the Pennig fixator incorporate a jointed body so permitting early movement.