Colles Fracture

Background

  • Common fracture of the distal radius/wrist
  • Usually caused by fall on outstretched hand
  • Particularly at risk are middle-elderly aged women who suffer from osteoporosis

Presentation

  • Swelling above the wrist; the wrist may be displaced posteriorly (dorsally)- producing classical ‘dinner-fork’ malformation
  • The wrist will be tender and there may be associated median nerve damage causing tingling/numbness of the radial 3 digits
  • It will be painful to move the wrist at all

Investigation

  • AP and true lateral view x-rays are required for the diagnosis
    • Show dorsal angulation of the joint; proximal displacement of the distal fragment of the radius (shortening of the wrist)
    • There may also be other fractures e.g. ulnar styloid or carpal bones

Management

  • Closed reduction is usually possible, followed by immobilisation in plaster of paris cast which holds the wrist in partial flexion, ulnar deviation and pronation
  • Open reduction and internal fixation can be considered when closed reduction is inadequate or failed (>10 degrees dorsal angulation; >5mm shortening; significant comminution)
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