The document discusses different types of wrist fractures, specifically Colles', Smith's, and Barton's fractures. It outlines their characteristics, common causes, diagnosis, treatment options, and potential complications. The information highlights the importance of appropriate interventions depending on the nature of the fracture and the patient's circumstances.

1. By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Colles’ fracture

2. • Fracture at distal end of radius at its cortico-
cancellous junction (2 cm from the distal
articular surface).
• Displacement is usual.
• Common in in people above forty years of age
especially in women due to postmenopausal
osteoporosis
• FOOSH injury

3. Pathoanatomy
• Fracture line runs transversely at the cortico
cancellous junction.
• Common displacement
• AP view :- Proximal shift, Radial shift, Radial
tilt
• Lateral view :- Proximal shift, Dorsal shift,
Dorsal tilt

4. • Some amount of comminution can happen.
• Some of associated injuries are
– Fracture of styloid process of ulna
– Rupture of ulnar collateral ligament, triangular
cartilage of ulna
– Subluxation of radio ulnar joint due to rupture of
interosseous radio-ulnar ligament

5. Diagnosis
• Pain, swelling deformity at wrist
• Tenderness and irregularity of the lower end
of radius is found
• “Dinner fork deformity”
• Radial styloid process lies at same level or at
higher level then ulnar styloid process
• Important to differentiate from smith and
bartons fracture

7. Treatment
• Undisplace fracture:- immobilization in below
elbow plaster cast
• Displaced :- Closed reduction and
immobilization
• 6 week immobilization
• Chances of redisplacement is higher in
comminuted fracture
• Adult with dominant hand, surgery is
recommended

8. • Percutaneous K wire fixation is done.
• External fixation can also be used in case of
comminuted fracture. Fracture fragments are
kept in distraction so that stretched soft
tissues will keep fragments in alignment
• LCP (Locking compression plate)

10. Complications
1. Stiffness of joints
2. Malunion
3. Subluxation of inferior radio ulnar joint
– Minor degree of displacement is acceptable
– Treatment is ulna head excision
4. Carpal Tunnel Syndrome
– Treatment is decompression of carpal tunnel

11. 5. Sudecks osteodystrophy
– Commonest cause of sudecks dystrophy
– Noticed after removal of plaster cast
– Patient complaints of pain, stiffness and swelling
of the hand.
– Overlying skin appears stretched and glossy
– Treatment is physiotherapy.

12. 6. Rupture of extensor pollices longus tendon
– May be due to blood circulation rupture or due to
friction at sharp edge of malunited fracture

13. By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Smith’s fracture

15. • It is reverse of colles’ fracture
• Seen in adult and in elderly patient
• Distal fragment displaces ventrally and tilts
ventrally
• Treatment is closed reduction and plaster cast
immobilization
• Complications are same as colles’ fracture

16. By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Barton’s fracture

17. • Intra-articular fracture
• Fracture extends from articular surface of the
radius to either anterior or posterior direction
• Distal fragment gets displaced
• Types :- Volar or Dorsal

18. • Closed manipulation and a plaster cast
• ORIF may required

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