More common in women because of post-menopausal osteoporosis.This is a Salter I or II fracture with the deforming forces directed through the weaker epiphyseal plate. In children with open epiphyses, an equivalent fracture is the "epiphyseal slip", as can be seen in other joints, such as a slipped capital femoral epiphysis in the hip. Younger individuals tend to require a higher energy force to cause the fracture and tend to have more complex intra-articular fractures.In the elderly, because of the weaker cortex, the fracture is more often extra-articular.Epidemiology Ĭolles fractures occur in all age groups, although certain patterns follow an age distribution. Recovery time depends on the degree of bone displacement, the number of bone fragments, whether or not the break is "intra-articular" (involves the wrist joint), as well as the person's age, gender, and medical history, and may range from two months to a year or more for complete recovery. Repeat Xrays are recommended at one, two, and six weeks to verify proper healing. Treatment modalities differ in the elderly. There are several established instability criteria: Ī higher amount of instability criteria increases the likelihood of operative treatment. The volar forearm splint is best for temporary immobilization of forearm, wrist and hand fractures, including Colles fracture. Significant angulation and deformity may require an open reduction and internal fixation or external fixation. There is some evidence that immobilization with the wrist in dorsiflexion as opposed to palmarflexion results in less redisplacement and better functional status. A fracture with mild angulation and displacement may require closed reduction. The cast is applied with the distal fragment in palmar flexion and ulnar deviation. An undisplaced fracture may be treated with a cast alone. Management depends on the severity of the fracture. Ĭolles' fractures can be categorized according to several systems including Frykman, Gartland & Werley, Lidström, Nissen-Lie and the Older's classifications. The fracture is sometimes referred to as a " dinner fork" or " bayonet" deformity due to the shape of the resultant forearm. Colles himself described it as a fracture that “takes place at about an inch and a half (38mm) above the carpal extremity of the radius” and “the carpus and the base of metacarpus appears to be thrown backward”. However, the term now tends to be used loosely to describe any fracture of the distal radius, with or without involvement of the ulna, that has dorsal displacement of the fracture fragments. The term Colles fracture is classically used to describe a fracture at the distal end of the radius, at its cortico-cancellous junction. Associated fracture of the ulnar styloid process in more than 60% of cases.dorsal displacement and dorsal angulation, together with radial tilt.2.5 cm (0.98 inches) proximal to the radio-carpal joint. The classic Colles fracture has the following characteristics: Diagnosis Colles fracture of the left hand, with posterior displacement clearly visibleĭiagnosis can be made upon interpretation of anteroposterior and lateral views alone. Colles fracture is a common fracture in people with osteoporosis, second only to vertebral fractures. It usually occurs about three to five centimetres proximal to the radio-carpal joint with posterior and lateral displacement of the distal fragment resulting in the characteristic "dinner fork" or "bayonet" like deformity. Originally it was described in elderly and/or post-menopausal women. The fracture is most commonly caused by people falling onto a hard surface and breaking their fall with outstretched hand (FOOSH)–falling with wrists flexed would lead to a Smith's fracture. The fracture is named after Abraham Colles who described it in 1814. Women are more frequently affected than men. They occur more commonly in young adults and older people than in children and middle-aged adults. Ībout 15% of people have a Colles' fracture at some point in their life. A year or two may be required for healing to occur. Pain management can be achieved during the reduction with procedural sedation and analgesia or a hematoma block. Surgical reduction and casting is possible in the majority of cases in people over the age of 50. Treatment may include casting or surgery. The diagnosis may be confirmed via X-rays. It typically occurs as a result of a fall on an outstretched hand. Complications may include damage to the median nerve. Symptoms may include pain, swelling, deformity, and bruising. A Colles' fracture is a type of fracture of the distal forearm in which the broken end of the radius is bent backwards.
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