Colles' fracture

Revision as of 23:11, 10 September 2016 by ClaireLewis (talk | contribs) (See Also)

Background

  • Distal radial metaphysis fracture that is dorsally displaced and angulated
    • Fracture line may extend into radioulnar or radiocarpal joint ("die-punch" fracture)
  • Occurs due to FOOSH
  • Ulnar styloid fracture 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)

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

Evaluation

Colles fracture

Imaging

  • PA
    • Distal metaphyseal fracture that often appears shortened from angulation or comminution
  • Lateral
    • Provides best view of dorsal angulation and comminution

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

References