Colles' fracture
Background
- Distal radial metaphysis fx that is dorsally displaced and angulated
- Fracture line may extend into radioulnar or radiocarpal joint ("die-punch" fx)
- Occurs due to FOOSH
- Ulnar styloid fx is often present and suggests injury to TFCC
Clinical Features
- Characteristic dorsiflexion or "dinner-fork" deformity
- Palmar paresthesias (pressure on median nerve)
Diagnosis
Imaging
- PA
- Distal metaphyseal fx that often appears shortened from angulation or comminution
- Lateral
- Provides best view of dorsal angulation and comminution
Differential Diagnosis
Distal radius fractures
- Colles' fracture
- Smith's fracture
- Barton's fracture
- Radial styloid fracture
- Distal radioulnar joint disruption
Distal radius fracture eponyms
Eponyms | Description |
Barton's | Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip) |
Chauffer's | Fracture of radial styloid |
Colles' | Dorsally displaced, extra-articular fracture |
Die-punch | Depressed fracture of the lunate fossa (articular surface) |
Smith's | Volar displaced, extra-articular fracture |
Management
- Assess for instability:
- >20 degrees angulation
- Intra-articular involvement
- Marked comminution
- >1cm shortening
- Stable Fracture
- Compression dressing and sugar tong splint
- Closed reduction may be attempted
- Unstable Fracture
- Immediate ortho referral
See Also
Source
- Tintinalli