12/1/2023 0 Comments Colles fracture wristDistal radius fractures can also pierce the skin resulting in an open fracture. When the distal radius is broken into many small pieces of bone as in a crush injury, it is deemed a comminuted fracture. These intra- or extra-articular fractures can either be displaced or alignment can be maintained. A fracture of the distal radius can be intra- or extra-articular, depending on whether the fracture extends into the wrist joint. Smith fractures, Chauffer’s fractures, and Barton’s fractures- other types of distal radius fractures- are also included under the umbrella of distal radius fractures.ĭistal radius fractures are further classified based on certain characteristics. At present time in the United States, and for the purposes of this article, we will refer to all distal radius fractures as Colles Fractures. It is commonly called a “broken wrist” although the distal radius is the location of the fracture, not the carpal bones of the wrist.įractures of the distal radius are extremely common and historically several methods of classification have been proposed. >10 degrees dorsal angulation >5 mm shortening significant comminution) 1.A true Colles Fracture is a complete fracture of the radius bone of the forearm close to the wrist resulting in an upward (posterior) displacement of the radius and obvious deformity. 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 immobilisation. 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).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |