38.107.191.119
MedPix® Medical Image DatabaseDisease Topic 3162
(Reviewed and Approved) :: Link to this Topic
Click Here for MedPix®-2
» » - - Print Topic - - « «
Contributor: Melissa Chiasson
Scroll to Bottom to Display Images (if available)
More Like This ? Colles' Fracture
Factoid 3162 - Created: 2001-10-16 17:06:52-04 - Modified: 2002-11-07 14:54:47-05
ACR Codes: 4.4
In 1814 Abraham Colles of Dublin described this common fracture based upon its clinical findings. He stated "this fracture takes place at about an inch and an half above the carpal extremity of the radius" and continued to describe a depression of the forearm at this site and swelling over the wrist and metacarpals. He stated the carpus in the base of the metacarpus appeared to be "thrown backward" thus making him suspicious that the carpus had been dislocated forward.


Occurs primarily in older women, increasing in incidence after 45 years. Commonly occurs in conjuction with other fractures (hip, ulnar, radial head, proximal humerus)

-Etiology and Pathogenesis:
Caused by a fall on an outstretched hand on the thenar eminence, thus compressing the dorsal distal radius while providing tension on the anterior distal radius. As a result a compression fracture occurs with a transverse fracture of the anterior cortex.
   
-Radiologic findings:
AP view: transverse fracture of distal radius often comminuted
60% of the time an ulnar styloid fracture is apparent
Lateral view: Elimination or reversal of the radiocarpal angle (normally 10-15 degrees)
       Distal radial fragment is displaced dorsally.
Frykman Classification: divides Colles' fracture into 8 subtypes based upon radiographic findings.

-Clinical Manifestations:
Clinically (as Colle described) there is marked wrist deformity and swelling. And when viewed from the side a dinner-fork deformity is seen (due to the posterior angulation of the hand and carpus)


-Differential Diagnosis:
   Smith's Fracture: fracture of the distal radius, with the distal fragment displaced anteriorly

-Diagnosis: AP and lateral Xray

-Treatment: Closed reduction with casting of the hand in palmar flexion and ulnar deviation. Some recommend neutral position or supination.
   Pain, limited range of motion, loss of grip strength, acute carpal tunnel syndrome can occur even after appropriate reduction.
Reference(s):
Rogers, Lee ed. Radiology of Skeletal Trauma. 2nd ed. New York: Churchill Livingsone, 1992. pp. 841-842.
Display Images - || - Image Slide Sorter
Location:
MSK - Musculoskeletal
Sublocation:
none selected
Category:
Trauma
More Like This ? - Find Related Topics: Click on the Location, Sublocation, or Category Links Above
Send this Search to ... More Like This ?  - - CHORUS - - Google™
Written by: Melissa Chiasson
Prepared by:
Gloria Jicha
Affiliation: Tripler Army Medical Center - || - Author Profile
Approved by: Donald J Flemming
Affiliation: Penn State University - || - Editor Profile
-


Use this MedPix® Visitor Feedback Form for Comments and Suggestions


MedPix® is sponsored by the Department of Radiology and Radiological Sciences, USUHS, Bethesda, MD
We do not accept paid advertisements.

This website is accredited by Health On the Net Foundation. Click to verify. We comply with the HONcode standard
for trustworthy health information:
verify here.


Text and Images may be Copyrighted © 1999 - 2009 by the Original Content Contributors.
Copyrighted materials are reproduced here with their Permission.

MedPix® is a Registered Trademark of USUHS :: The MedPix® Database Engine is Patented - USPTO No. 7,080,098
Portions of MedPix® are Copyright © 1999 - 2009 by J.G. Smirniotopoulos, M.D. & H. Irvine, M.D.
The MedPix® Classification Schema Copyright © 1999 - 2009 by J.G.Smirniotopoulos,M.D.
MedPix® has displayed more than   266,870,834   pages since 3 September 2000.

Database Successfully Disconnected