colles fracture

Question 1

mech of injury for colles fracture

Answer 1

FOOSH

Question 2

deformity seen in Colles fracture

Answer 2

Distal radius fracture with dorsal displacement of fragments
‘dinner fork deformity’

Question 3

features of colles fracture

Answer 3

Transverse fracture of the radius
1 inch proximal to the radio-carpal joint
Dorsal displacement and angulation

Question 4

complication of colles fracture

Answer 4

early
* median nerve injury: acute carpal tunnel syndrome presenting with weakness or loss of thumb or index finger flexion
* compartment syndrome
* vascular compromise
* malunion
* rupture of the extensor pollicis longus tendon

late
* osteoarthritis
* complex regional pain syndrome

Question 5

presenting signs and sx of colles fracture

Answer 5

wrist pain and swelling
wrist deformity
parasthesia and weakness - median nerve

Question 6

ix for colles fracture

Answer 6

plain XR- AP and lateral view

Question 7

smith’s fracture

Answer 7

volar angulation
volar displacement
garden spade deformity
due to fall on flexed wrist

Question 8

Answer 8

smith fracture

Question 9

barton fracture

Answer 9

This is similar to a Colles’ fracture, however, a Barton’s fracture is intra-articular with dislocation of the radio-carpal joint
Barton’s fractures can be volar or, less commonly, dorsal, depending on which margin of the radius is affected

Question 10

mx of colles fracture

Answer 10

closed reduction
immobilisation with plaster cast

open reduction with internal fixation if:
* Unstable fracture
* Significant angulation of the distal fragment of the radius
* Usually defined as >10 degrees dorsal angulation
* Closed reduction is unsuccessful
* Comminuted fracture

usually unite by 6wks - repeat XRs

Question 11

complications of colles fracture

Answer 11

malunion
median nerve damage
rupture of extensor pollicis longus
secondary OA of the radio-carpal joint

Question 12

galeazzi fracture

Answer 12

fracture of radius
at junction of the middle distal 3rd of radial shaft
children more

Question 13

galeazzi fracture

Answer 13

• Radial shaft fracture with associated dislocation of the distal radioulnar joint
• Occur after a FOOSH with a rotational force superimposed on it.
• bruising, swelling and tenderness over the lower end of the forearm.
• X Rays reveal the displaced fracture of the radius and a prominent ulnar head due to dislocation of the inferior radio-ulnar joint.

Question 14

bennet fracture

Answer 14

Intra-articular fracture at the base of the thumb metacarpal
Impact on flexed metacarpal, caused by fist fights
X-ray: triangular fragment at the base of metacarpal

Question 15

radial head fracture

Answer 15

• Fracture of the radial head is common in young adults.
• It is usually caused by a FOOSH
• marked local tenderness over the head of the radius,
• impaired movements at the elbow,
• sharp pain at the lateral side of the elbow at the extremes of rotation (pronation and supination).