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$Colles smith fracture$

$colles smith fracture$

#COLLES SMITH FRACTURE SKIN#

Tenderness in the anatomical snuffbox is suggestive of scaphoid fracture.Īn isolated and non-complicated low energy fracture is itself a red flag: it may reflect previously undetected osteoporosis or other metabolic bone disease. Scaphoid fractures, scapholunate ligament injury, and fractures of the ulnar styloid process are injuries associated with distal radius fractures, given their anatomic proximity to the distal radius.

#COLLES SMITH FRACTURE SKIN#

skin broken or not) and whether there are associated injuries.Ĭoncomitant injuries must be excluded, including shoulder, elbow and neurovascular injuries. The classification of these fractures should consider whether they are intra- vs extra-articular displaced vs non-displaced comminuted or not open or closed (i.e. These are categorized as “fragility fractures” meaning that weakness of the bone contributes to the cause.ĭistal radius fractures are detected on imaging. from a simple fall on outstretched hand from standing height or lower.

$colles smith fracture$

In older people, distal radius fractures are typically lower energy injuries, i.e. In younger people, high energy injuries are more common, such as those from motor vehicle collisions, motorcycle collisions, sports, or falls from an extended height. Distal radius fractures have a bimodal distribution: one peak in the 18-25 year old age group and another in the 65 and older age group. Normal radial height is approximately 12 mm and is decreased in distal radius fractures.ĭistal radius fractures are one of the most common fractures of the upper extremity, and therefore, represent a large proportion of fractures seen by Primary Care physicians and Emergency Medicine physicians. The first line is drawn tangential to the distal tip of the radial styloid and the second tangential to the distal ulna, (Figure 2). Radial height is the distance between two parallel lines perpendicular to the long axis of the radius. Three measurements on PA films allow for characterization of the injury: radial height, radial inclination, and palmar (volar) tilt PA radiographs allow for evaluation of the integrity of the distal radio-ulnar joint, the radiocarpal joint, the proximal carpal row, and the radial and ulnar styloid processes. All three radiographs should be examined for a loss of normal anatomy, disruption of the articular surface, involvement of the distal radio-ulnar and radiocarpal joints, and evidence of comminution. PA, lateral, and oblique radiographs of the distal radius that include the carpal bones should be obtained. (The latter three should remind you of the rule "Always assess the joints above and below the known injury.")

Acute carpal tunnel syndrome (characterized by weakness or loss of thumb or index finger flexion, tingling or alterations of sensation in the median distribution).

Physical examination (and imaging) should assess for the following: This information can alert the clinician to the presence of associated injuries (in the case of high energy mechanisms, such as motor vehicle accidents) or the presence of osteoporosis (in the case of low energy mechanisms, such as a fall from a standing height). History-taking should focus on the mechanism of injury and amount of energy involved. The deformity that results from the Colles’ fracture is described as a “dinner fork" deformity because of depression at the fracture site, dorsal angulation, and dorsal displacement of the distal radius. He or she will complain of wrist pain and swelling. This makes fractures more likely, especially in patients with decreased bone mineral density.Ī patient with a fracture of the distal metaphysis of the radius typically describes falling on an outstretched hand or sustaining a direct blow to the wrist. The distal metaphysis of the radius is therefore a relative weak point. On the lateral side of the radius is a styloid process, onto which the brachioradialis inserts and from which the radial collateral ligament of the wrist originates.Īt the distal metaphysis of the radius, the cortex of the bone is thinner than the bone proximal and distal, and the relative amount of cancellous bone increases. The distal ulna attaches to a meniscus-like structure, the triangular fibrocartilage discus, which can be torn with wrist fractures. There, the radius articulates with the proximal row of carpal bones (allowing flexion and extension) it also articulates with the distal ulna (creating a joint for pronation and supination). The distal radius forms the proximal side of the wrist joint.

$Colles smith fracture$