Colles’ Fracture

Hema N. Choudur, Anthony G. Ryan, and Peter L. Munk

A young athlete fell on an outstretched hand while skiing. She had acute pain and swelling along the distal aspect of the forearm. On examination, there was limitation of wrist movements. No sensory/motor deficit was elicited. The radial pulse was normal.

Figure 86A

Figure 86B

Colles’ fracture.

• Smith’s fracture with volar displacement of the distal fractured fragment
  
• Barton’s fracture, an intra-articular fracture of the dorsal aspect of the distal radius
  
• Chauffeur’s fracture, base of the radial styloid fracture with intra-articular extension

Colles’ fracture is the most common fracture in the region of the distal forearm and hand. It was first described by an Irish surgeon, Abraham Colles (1773–1843).

It is commonly seen in women with postmenopausal osteoporosis. Of note, elderly men with Colles’ fracture are prone to future hip fractures and therefore should be investigated and, if necessary, treated for osteoporosis. Further, the morbidity/mortality following a hip fracture in men is higher than in women.

Colles’ fracture is mostly caused by a fall on an outstretched hand. It can also result from motor vehicle accidents. The injury is encountered in both sexes and in all age groups, but it is most common in post-menopausal women, osteoporosis being the predisposing factor. In the younger population, this injury is common to ice hockey, football, rugby, and handball players, as well as riders, wrestlers, and Alpine skiers.