Colles Fracture: Difference between revisions

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We consulted Pubmed to search for randomized clinical trials. These are the words we used: Colles’ fracture physical therapy, colles’ fracture epidemiology, distal radius fracture, treatment colles fracture..<ref name="Wheeless" /><br>  
We consulted Pubmed to search for randomized clinical trials. These are the words we used: Colles’ fracture physical therapy, colles’ fracture epidemiology, distal radius fracture, treatment colles fracture..<ref name="Wheeless" /><br>  


== Clinical Presentation  ==
== Definition/Description&lt;br&gt;==<br>A colles fracture is a fracture of the distal radius. It was first described in 1814, by Abraham Colles, an Irish surgeon. The fracture originates from a fall on the outstretched hand and is usually associated with dorsal and radial displacement of the distal fragment, and disturbance of the radial-ulnar articulation. Possibly the ulnar styliod may be fractured. Communication of the distal fragment and fractures into the joint surface are present in some of these fractures. The colles fracture is one of the most common and challenging of the outpatient fractures. (7: Level of Evidence 1B) Colles' fracture is defined as a linear transverse fracture of the distal radius approximately 20-35 mm proximal to the articular surface with dorsal angulation of the distal fragment.(3: Level of evidence 4 ) <br>
 
[[Image:Colles Fracture 2.jpg|thumb|right|200px|Dinner Fork Deformity]]
 
*"Dinner Fork" Deformity<ref name="EMedicine">Hoynak BC, Hopson L. EMedicine. Wrist Fractures. http://emedicine.medscape.com/article/828746-overview (Acessed 2 July 2009).</ref>
*History of fall on an outstretched hand  
*Dorsal wrist pain
*Sweling of the wrist
*Increased angulation of the distal radius
*Inability to grasp object<ref name="Medline">Joseph TN. Medline Plus. Colles' Wrist Fracture. http://www.nlm.nih.gov/medlineplus/ency/article/000002.htm (Accessed 2 July 2009).</ref>


== Diagnostic Procedures  ==
== Diagnostic Procedures  ==

Revision as of 19:19, 13 June 2013

Original Editor - Stacy S Stone


Lead Editors - Emma Guettard as part of the Vrije Universiteit Brussel Evidence-based Practice Project


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Top Contributors - Emma Guettard, Admin, Adam Vallely Farrell, Kim Jackson, Stacy S Stone, Laura Ritchie, Rachael Lowe, Anne-Laure Vanherwegen, Nikhil Benhur Abburi, Lauren Lopez, Lucinda hampton, Anas Mohamed, Evan Thomas, Scott Buxton, Priyanka Chugh, Benjamin Desmedt, WikiSysop and Claire Knott  

Definition/Description[edit source]

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Clinically Relevant Anatomy[edit source]

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Epidemiology /Etiology[edit source]

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Characteristics/Clinical Presentation[edit source]

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Differential Diagnosis[edit source]

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Diagnostic Procedures[edit source]

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Outcome Measures[edit source]

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Examination[edit source]

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Medical Management
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Physical Therapy Management
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Key Research[edit source]

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Resources
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Clinical Bottom Line[edit source]

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References[edit source]

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== Search Strategy<br> ==
We consulted Pubmed to search for randomized clinical trials. These are the words we used: Colles’ fracture physical therapy, colles’ fracture epidemiology, distal radius fracture, treatment colles fracture.
==

 ==Search strategy==
 [edit | edit source]

We consulted Pubmed to search for randomized clinical trials. These are the words we used: Colles’ fracture physical therapy, colles’ fracture epidemiology, distal radius fracture, treatment colles fracture..[1]

== Definition/Description<br>==
A colles fracture is a fracture of the distal radius. It was first described in 1814, by Abraham Colles, an Irish surgeon. The fracture originates from a fall on the outstretched hand and is usually associated with dorsal and radial displacement of the distal fragment, and disturbance of the radial-ulnar articulation. Possibly the ulnar styliod may be fractured. Communication of the distal fragment and fractures into the joint surface are present in some of these fractures. The colles fracture is one of the most common and challenging of the outpatient fractures. (7: Level of Evidence 1B) Colles' fracture is defined as a linear transverse fracture of the distal radius approximately 20-35 mm proximal to the articular surface with dorsal angulation of the distal fragment.(3: Level of evidence 4 )

Diagnostic Procedures[edit | edit source]

  • Radiographic Imaging - dorsally angulated fracture of distal radial metaphysis
  • CT Scan

Classifications of Distal Radial (Colles') Fracture

  • Universal Classification of Dorsally Displaced Distal Radial Fractures Type I - undisplaced
  • Universal Classification of Dorsally Displaced Distal Radial Fractures Type II - displaced
  • Melone Type I - undisplaced and minimally comminuted
  • Frykman Type I - distal radial fracture without distal ulnar fracture
  • Frykman Type II - distal radial fracture with distal ulnar fracture[1]

Outcome Measures[edit | edit source]

  • DASH
  • Patient Rated Wrist Evaluation (PRWE)
  • Green Score
  • O'Brian Score [2][3][4][5]

Management / Interventions
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[6]

Conservative Treatment

  • Immobilization in cast/splint - typically positioned in slight flexion, pronation
  • Percutaneous Pinning

Surgical Intervention

Differential Diagnosis
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Must differentially diagnose a Colles' Fracture from:

  • Carpal fracture/dislocation (particularly scaphoid and lunate)
  • Distal ulnar fracture
  • Metacarpal fracture[7]

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Resources
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add appropriate resources here


Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ 1.0 1.1 1.2 Cite error: Invalid <ref> tag; no text was provided for refs named Wheeless
  2. ↑ MacDermid JC, Roth JH, Richards RS. Pain and disability reported in the year following a distal radius fracture: a cohort study. BMC Musculoskeletal Disord. 2003;4:24.
  3. ↑ Arora R, Gabl M, Gschwentner M, Deml C, Krappinger D, Lutz M. A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237-242.
  4. ↑ Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. 2005;30(2):289-299.
  5. ↑ Tremayne A, Taylor N, McBurney H, Baskus K. Correlation of impairment and activity limitation after wrist fracture. Physiother Res Int. 2002;7(2):90-99.
  6. ↑ besthandsurgeon. Distal Radius Fracture ORIF. Available from: http://www.youtube.com/watch?v=Ye839BYoMaY[last accessed 22/03/13]
  7. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named EMedicine
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