Fractures of the distal radius Colles' fracture. Address for correspondence. The aim of the present study was to investigate Brazilian orthopedists' opinions regarding the main aspects of treatments for Colles' fracture. METHODS: Five hundred questionnaires containing 12 items were randomly distributed to orthopedists who were attending the congress; were filled out correctly and were considered in this study.
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They consist of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without the involvement of the articular surface. This article describes radiographic features to check for and possible complications. They are particularly common in patients with osteoporosis , and as such, they are most frequently seen in elderly women. The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated 1.
Younger patients who sustain Colles fractures have usually been involved in high impact trauma or have fallen, e. Most Colles fractures are secondary to a fall on an outstretched hand FOOSH with a pronated forearm in dorsiflexion the position one adopts when trying to break a forward fall. The proximal row of the carpus particularly the lunate and scaphoid transfer energy to the distal radius, both in the dorsal direction and along the long axis of the radius.
Most fractures are therefore dorsally angulated and impacted. A number of classification systems exist for distal forearm fractures. One of the more popular is the Frykman classification system , although it fails to distinguish between Smith and Colles fractures as it is based on AP radiographs As such, in clinical practice, the use of the term Colles fracture with an appropriate description of any associated injuries is sufficient in most instances.
Plain films usually suffice, although if there is a concern of intra-articular extension, then CT may be beneficial. The plain radiographic series often comprises an AP and a lateral view; however, it is not uncommon for an oblique view to be included. The fracture appears extra-articular and usually proximal to the radioulnar joint.
Dorsal angulation of the distal fracture fragment is present to a variable degree as opposed to volar angulation of a Smith fracture. If dorsal angulation is severe enough, a dinner dinner fork deformity may be described.
There is also usually impaction with resultant shortening of the radius. In addition to noting the presence of a fracture a number of features should be sought and commented upon:.
The vast majority of Colles fractures can be treated with closed reduction and cast immobilization. The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation 4 - for those of you familiar with Australian rules football; this position is reminiscent of the position adopted when holding a ball in preparation for a kick.
This cast is known as a Colles cast 4. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
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URL of Article. Article information. Systems: Musculoskeletal , Trauma. Tags: fracture , wrist , eponymous , fracture. Synonyms or Alternate Spellings: Colles' fracture Colles fractures. Support Radiopaedia and see fewer ads. Cases and figures. Figure 1: Colles fracture illustration Figure 1: Colles fracture illustration. Case 1 Case 1. Case 2 Case 2. Case 3 Case 3. Case 5 Case 5. Case 6 Case 6. Case 7 Case 7. Case 8 Case 8. Imaging differential diagnosis.
Case 1: normal radial beak Case 1: normal radial beak. Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Loading Stack - 0 images remaining. By System:. Patient Cases. Contact Us.
Average 4. Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine. Just skip this one for now. Immediate post-operative radiographs are seen in Figure A.
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A Smith's fracture , is a fracture of the distal radius. Smith's fractures are less common than Colles' fractures. The distal fracture fragment is displaced volarly ventrally , as opposed to a Colles' fracture which the fragment is displaced dorsally. Depending on the severity of the impact, there may be one or many fragments and it may or may not involve the articular surface of the wrist joint. Classic physical examination findings of a Smith's fracture is palmar displacement of the wrist that results in a "garden-spade deformity". PA radiography will look very similar to a Colles' fracture, with a fracture along the distal metaphysis of the radius can be shortened or comminuted. A commonly used classification of distal radial fractures is the Frykman Classification  :.