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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