COLLES' FRACTURE

Question 1

Mechanism

Answer 1

FOOSH

Question 2

History

Answer 2

Wrist pain, swelling, deformity

Question 3

Physical Exam

Answer 3

Ecchymosis and swelling
Diffuse tenderness
Dinner Fork Deformity Distal Radius
ROM limited by pain

Question 4

XRAY Findings

Answer 4

3V Wrist: AP, Lateral, Oblique
Impacted
Radially Deviated
Dorsally Displaced
Distal fragment is dorsally angulated
Often ulnar styloid fracture

Question 5

Normal wrist values on XRAY

Answer 5

Distal radius should tilt 11 degrees volarly (palmar tilt)
Distal radius should extend 11 mm beyond the end of the ulna

Question 6

Associated Injuries

Answer 6

DRUJ
Radial Styloid
Ulnar Styloid

Question 7

ED Management: no reduction

Answer 7

Well molded splint in slight flexion and ulnar deviation
Follow up with ortho within a week

Question 8

ED Management: reduction required

Answer 8

Well molded spint
Flexion and ulnar deviation
Post reduction XRAY
Follow up with ortho within several days

Question 9

Wrist dysfunction post Colles Fracture

Answer 9

loss of palmar tilt (11 degrees)
Shortening of distal radius (< 11 mm)

Question 10

Factors affecting distal radius fracture instability

Answer 10

Comminuted
Significant angulation / displacement (>20 degrees)
Intra-articular
> 1 cm shortening

Question 11

Complications

Answer 11

Malunion
Median n. neuropathy
Triangular fibrocartilage complex injuries
EPL Rupture
FPL Rupture
Radioulnar and radiocarpal instability
Arthritis