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Colles Fracture
From WikiSM
(Redirected from Colles' Fracture)
Other Names
- Distal radius fracture
- Colle's fracture
Background
- This page refers to Colles fracture, the most common extra-articular fracture of the distal Radius
Pathophysiology
- Fracture of the distal radial metaphyseal region with dorsal angulation and impaction
- Commonly occurs as a result of fall on outstretched hand (FOOSH)
- Forearm pronated in dorsiflexion (as if to brace for the fall)
- Most common distal radius fracture (need citation)
Risk Factors
Differential Diagnosis
Distal Radius Fractures
- Barton's Fracture
- Chauffer's Fracture
- Colles' Fracture
- Die-Punch Fracture
- Radial Styloid Fracture
- Smith's Fracture
Differential Diagnosis Wrist Pain
- Fractures
- Dislocations
- Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
- Carpometacarpal Joint Dislocation
- Distal Radioulnar Joint Dislocation
- Lunate Dislocation
- Perilunate Dislocation
- Instability & Degenerative
- Tendinopathies & Ligaments
- Neuropathies
- Pediatric Considerations
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Torus Fracture
- Arthropathies
- Cartilage
- Vascular
- Other
Clinical Features
- General: Physical Exam Wrist
- Typically swelling, ecchymosis, deformity
- Tenderness to palpation
Evaluation
Radiographs
- Standard Radiographs Wrist
- Sufficient to make diagnosis
- Fracture is extra-articular, typically proximal to DRUJ
- The fracture fragment is dorsally angulated
- Up to 50% of cases have an associated Radial Styloid Fracture
Classification
- Not applicable
Management
Nonoperative
- Most can be managed nonoperatively
- Requires closed reduction, splinting or casting
- Splint: Sugar Tong Splint
- Cast: Short Arm Cast
Operative
- Indications
- Unstable Fracture
- Unsatisfactory closed reduction
- > 10° dorsal angulation
- > 5 mm shortening
- significant comminution
Return to Play
- Nonoperative will require at least 6 weeks
- Surgically managed cases at the discretion of the surgeon
Complications
- Median Nerve Neuropathy
- Ulnar Nerve Neuropathy
- EPL Rupture
- FPL Rupture
- Radiocarpal Arthropathy
- Malunion or Nonunion
- ECU or EDM Entrapment
- Acute Compartment Syndrome
- RSD/ CRPS
- Distal Radioulnar Joint Disruption
- TFCC Injury
- Scapholunate Instability (DISI)
- Lunotriquetral Instability (VISI)
See Also
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/