Colles' fracture

Revision as of 22:05, 29 December 2014 by Rossdonaldson1 (talk | contribs) (Management)

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
Colles fracture

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

  • 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