T&O: Distal Radial Fractures Flashcards

1
Q

what is the most common type of fracture in the elderly?

A

Colles fracture (90% of all distal radial fractures) - high incidence related to onset of post-menopausal osteoporosis.

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2
Q

describe the differences between Colles fracture and Smith’s fracture?

A

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
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3
Q

how would you manage a Colles or Smith’s fracture?

A
  • 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
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4
Q

suggest possible complications of Colles fracture

A
  1. malunion - resulting in dinner fork deformity
  2. median n. palsy and post-traumatic carpal tunnel syndrome
  3. complex regional pain syndrome
  4. secondary OA
  5. EPL tendon tear
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5
Q

suggest possible complications of Smith’s fracture

A
  1. malunion - resulting in garden spade deformity

2. median n. palsy and post-traumatic carpal tunnel syndrome

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6
Q

what is Barton’s fracture and how is it managed?

A

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.

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7
Q

what is Chauffeur’s fracture?

A

Intra-articular fracture of radial styloid process

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8
Q

what is a Galeazzi fracture-dislocation?

A

Fracture of radial shaft (between middle and distal third) with dorsal angulation + dislocation of distal radio-ulnar joint.

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