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

Colle's fracture on physical exam.

• Characteristic dorsiflexion or "dinner-fork" deformity
• Palmar paresthesias (pressure on median nerve)

Diagnosis

Colles fracture

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

• 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

• Distal radius fractures

Source

• Tintinalli