![]() It can result from an impact to the back of the wrist, such as falling on a bent wrist. Smith fracture is the less common of the two types of wrist fractures. This appearance is due to the fractured end of the distal radius moving up toward the back of the hand. The wrist has a noticeable “bump” in it, comparable to the fork’s neck. ![]() The side view of a wrist following a Colles fracture resembles a fork looking down. For instance, it may occur when you use your hand with open palms to support yourself on landing from a fall. Colles FractureĬolles fracture occurs following direct impact to the palm of an outstretched hand. These features are classified as a Colles or Smith fracture depending on the angle at which the distal radius breaks. It can happen on its own or alongside a fracture to the distal ulna (the smaller forearm bone). Ī distal radius fracture typically occurs at approximately an inch from the bone’s end. When the radius breaks in this area, it is a distal radius fracture. The part of the radius which articulates with the carpal bones to form the wrist joint is called the distal end. The radius is one of the two forearm bones and is located on the thumb side of the hand. Originally named by Abraham Colles (1773-1843), an Irish surgeon.DISTAL RADIUS FRACTURES What is Distal Radius Fracture Secondary osteoarthritis: more frequently seen in patients with intra-articular involvementĮxtensor pollicis longus tendon tear: more common in non-displaced fractures 5 Median nerve palsy and post-traumatic carpal tunnel syndrome Malunion resulting in dinner fork deformity >10 degrees dorsal angulation >5 mm shortening significant comminution) 1. Open reduction and internal fixation (ORIF) is considered when the fracture is unstable, and/or unsatisfactory closed reduction is achieved (i.e. The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation 4 - for those of you familiar with Australian rules football this position is reminiscent of the position adopted when holding a ball in preparation for a kick. The vast majority of Colles fractures can be treated with closed reduction and cast immobilization. ![]() Location of the medial fracture line: does it involve the radioulnar joint In addition to noting the presence of a fracture a number of features should be sought and commented upon: An associated ulnar styloid fracture is present in up to 50% of cases.Ī pronator quadratus sign is generally seen. If dorsal angulation is severe enough, a dinner fork deformity may be described.There is also usually impaction with resultant shortening of the radius. Dorsal angulation of the distal fracture fragment is present to a variable degree (as opposed to volar angulation of a Smith fracture). The fracture appears extra-articular and usually proximal to the radioulnar joint. The plain radiographic series often comprises an AP and a lateral view however, it is not uncommon for an oblique view to be included. Plain films usually suffice, although if there is a concern of intra-articular extension, then CT may be beneficial. As such, in clinical practice, the use of the term Colles fracture with an appropriate description of any associated injuries is sufficient in most instances. One of the more popular is the Frykman classification system, although it fails to distinguish between Smith and Colles fractures as it is based on AP radiographs 2,3. Radiographic featuresĪ number of classification systems exist for distal forearm fractures. Most fractures are therefore dorsally angulated and impacted. The proximal row of the carpus (particularly the lunate and scaphoid) transfers energy to the distal radius, both in the dorsal direction and along the long axis of the radius. Most Colles fractures are secondary to a fall on an outstretched hand (FOOSH) with a pronated forearm in wrist extension (the position one adopts when trying to break a forward fall). during contact sports, skiing, horse riding 1. Younger patients who sustain Colles fractures have usually been involved in high impact trauma or have fallen, e.g. The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated 1. They are particularly common in patients with osteoporosis, and as such, they are most frequently seen in elderly women. Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics.
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