86 Colles’ Fracture

CASE 86


Colles’ Fracture


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


Clinical Presentation


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.



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Figure 86A



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Figure 86B


Radiologic Findings


Anteroposterior (AP) and lateral views (Figs. 86A, 86B) of the forearm show a transversely oriented fracture through the distal radial metaphysis with dorsal displacement of the distal fracture fragment. A concomitant ulnar styloid fracture is also present.


Diagnosis


Colles’ fracture.


Differential Diagnosis



  • 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

Discussion


Background


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.


Etiology


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.


Pathophysiology

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Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 86 Colles’ Fracture

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