Difference between revisions of "Colles' fracture"

(Clinical Features)
Line 23: Line 23:
  
 
==Management==
 
==Management==
*Assess for instability:
+
*Unstable Fracture - Immediate ortho referral
 
**>20 degrees angulation
 
**>20 degrees angulation
 
**Intra-articular involvement
 
**Intra-articular involvement
 
**Marked comminution
 
**Marked comminution
**>1cm shortening
+
**>2/3 displacement
*Stable Fracture
+
**5mm shortening of the radius
**Compression dressing and sugar tong splint
+
*Stable Fracture - Compression dressing and sugar tong splint
**Closed reduction may be attempted
 
*Unstable Fracture
 
**Immediate ortho referral
 
  
 
==See Also==
 
==See Also==

Revision as of 17:39, 2 January 2015

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

Colle's fracture on physical exam.
  • Characteristic dorsiflexion or "dinner-fork" deformity
  • Palmar paresthesias (pressure on median nerve)

Diagnosis

Colles fracture

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

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

  • Unstable Fracture - Immediate ortho referral
    • >20 degrees angulation
    • Intra-articular involvement
    • Marked comminution
    • >2/3 displacement
    • 5mm shortening of the radius
  • Stable Fracture - Compression dressing and sugar tong splint

See Also

Source

  • Tintinalli