Colles Fracture

Other Names

• Distal radius fracture
• Colle's fracture

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Background

• This page refers to Colles fracture, the most common extra-articular fracture of the distal Radius

History

• First described by Abraham Colles in 1814

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Introduction

Illustration of the typical mechanism of action of a Colle's fracture

• 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)

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Risk Factors

• Osteoporosis

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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
  • Distal Radius Fracture
    • Bartons Fracture
    • Chauffers Fracture
    • Colles Fracture
    • Die-Punch Fracture
    • Radial Styloid Fracture
    • Smiths Fracture
  • Distal Ulna Fracture
  • Carpal Fractures
    • Scaphoid Fracture
    • Lunate Fracture
    • Triquetrum Fracture
    • Pisiform Fracture
    • Trapezium Fracture
    • Trapezoid Fracture
    • Capitate Fracture
    • Hamate Fracture
  • Essex Lopresti Fracture
• Dislocations
  • Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
  • Carpometacarpal Joint Dislocation
  • Distal Radioulnar Joint Dislocation
  • Lunate Dislocation
  • Perilunate Dislocation
• Instability & Degenerative
  • Scapholunate Instability
  • Lunotriquetral Instability
  • Scaphoid Nonunion Advanced Collapse
  • Distal Radial Ulnar Joint Instability
  • Kienbocks Disease
  • Dorsal Wrist Impingement
  • Carpal Instability
• Tendinopathies & Ligaments
  • De Quervain's Tenosynovitis
  • Intersection Syndrome
  • TFCC Injury
  • Wrist Tendinopathies
  • Extensor Carpi Ulnaris Tendinopathy
• Neuropathies
  • Carpal Tunnel Syndrome
  • Pronator Teres Syndrome
  • Anterior Interosseus Nerve Syndrome
  • Posterior Interosseus Nerve Syndrome
  • Guyon Canal Syndrome
  • Wartenbergs Syndrome
• Pediatric Considerations
  • Distal Radial Epiphysitis (Gymnast's Wrist)
  • Torus Fracture
• Arthropathies
  • Wrist Osteoarthritis
  • Scaphotrapeziotrapezoidal Joint Arthritis (STT Arthritis)
  • Rheumatoid Arthritis
  • Gout
• Cartilage
  • Osteochondral Defect
• Vascular
  • Hypothenar Hammer Syndrome
• Other
  • Ganglion Cyst of Wrist
  • Ulnar Impingement Syndrome
  • Infectious Tenosynovitis

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Clinical Features

Clinical appearance of a Colles fracture with corresponding radiographic appearance

• General: Physical Exam Wrist
• Typically swelling, ecchymosis, deformity
• Tenderness to palpation

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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

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Classification

• Not applicable

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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

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Return to Play

• Nonoperative will require at least 6 weeks
• Surgically managed cases at the discretion of the surgeon

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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)

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See Also

• Internal
  • Forearm Pain (Main)
  • Wrist Pain (Main)
  • Hand and Wrist Anatomy (Main)
  • Physical Exam Wrist
• External
  • Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/

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