T&O: Distal Radial Fractures Flashcards
what is the most common type of fracture in the elderly?
Colles fracture (90% of all distal radial fractures) - high incidence related to onset of post-menopausal osteoporosis.
describe the differences between Colles fracture and Smith’s fracture?
Colles fracture:
- Hx of FOOSH
- extra-articular transverse fracture of distal radius, with dorsal angulation and dorsal displacement of distal fragment
- ‘dinner fork’ deformity
Smith’s fracture:
- Hx of fall onto flexed wrist or direct injury to back of wrist
- transverse fracture of distal radius, with volar angulation +/- volar displacement of distal fragment
- ‘garden spade’ deformity
how would you manage a Colles or Smith’s fracture?
- maj. treated with closed reduction and immobilisation (for Colles fracture: cast extends from elbow to metacarpal heads and holds wrist somewhat flexed and ulnar deviated)
- ORIF considered if fracture is unstable or unsatisfactor closed reduction
suggest possible complications of Colles fracture
- malunion - resulting in dinner fork deformity
- median n. palsy and post-traumatic carpal tunnel syndrome
- complex regional pain syndrome
- secondary OA
- EPL tendon tear
suggest possible complications of Smith’s fracture
- malunion - resulting in garden spade deformity
2. median n. palsy and post-traumatic carpal tunnel syndrome
what is Barton’s fracture and how is it managed?
Intra-articular oblique fracture of distal radius with associated dislocation of radio-carpal joint.
X-ray features:
- oblique radial fracture line running from volar surface of distal radius into wrist joint
- fragment often displaced anteriorly, carrying carpus with it as a fracture-dislocation
Management: ORIF (using small anterior buttress plate), usually recommended as often unstable and easily re-displaced.
what is Chauffeur’s fracture?
Intra-articular fracture of radial styloid process
what is a Galeazzi fracture-dislocation?
Fracture of radial shaft (between middle and distal third) with dorsal angulation + dislocation of distal radio-ulnar joint.