2. 52yo female presents to ED T 98.8 P 88 BP 156/78 O2
after slipping and falling 99%
forward on outstretched Gen- in obvious pain but
hand. Pt had obvious NAD
deformity to dorsal right
wrist, but no obvious MSK obvious deformity to
laceration. Pt states she fell dorsal wrist, TTP dorsal wrist.
on her extended hand as she 1+ radial pulse RUE, ROM
was trying to break her fall. limited 2/2 pain in right wrist.
She denies any other injuries, No laceration
no LOC. Neuro- 5/5 motor in all
extremities except right wrist,
which is limited by pain.
Sensory nl throughout except
for slight paresthesia over
thenar eminence.
3.
4. Distal Radius Fracture, with dorsal displacement/angulation of distal
fragment. Referred to as “Dinner Fork Deformity”
5. Pain control
Emergent Ortho consultation for all open fx or if radius unable to be
reduced
Prompt reduction necessary for:
Intra-articular step-off >1 mm
Radial inclination <15 degrees
Volar tilt less than neutral (0 degrees)
Shortening or loss of radial length greater than 2 mm as compared with
the opposite side
Urgent ortho consultation for the following, b/c los of reduction is
frequent
complicated fractures with significant displacement (more than 20
degrees of dorsal angulation),
marked dorsal comminution,
intra-articular extension
Sugar-tong splint if indicated (d/c with prompt ortho f/u)
6. Most common wrist fracture
Usually caused by FOOSH with extended wrist, often
in seen in elderly
Complications of improper reduction include arthritis
of wrist joint
Neurovascular exam important, for median nerve
injury possible
7.
8. http://rcpilibrary.blogspot.com/2010/12/winter-
weather-and-colles-fracture.html
http://www.radiologyassistant.nl/en/476a23436683b
http://www.worldortho.com/dev/index.php?option=c
om_content&task=view&id=1116&Itemid=430
http://www.wheelessonline.com/ortho/colles_frx
Rosen’s emergency medicine : concepts and clinical
practice / editor-in-chief, John A. Marx ; senior editors,
Robert S. Hockberger, Ron M. Walls ; editors, James G.
Adams ... [et al.].—7th ed.
