Colles' fracture is a common wrist injury that was first described in 1814. It typically occurs in osteoporotic women after a fall on an outstretched hand. The injury causes a "dinner fork" deformity of the wrist with dorsal angulation, displacement, and radial deviation. Early complications can include swelling, pain, median nerve damage, and Sudeck's atrophy. Late complications may involve malunion, nonunion, tendon damage, stiffness, or progression to Sudeck's atrophy. Sudeck's atrophy is a type of complex regional pain syndrome that can develop after an injury and cause long-term disability if not promptly diagnosed and treated.

1. 11/3/2009Colles’ fracture | dR.hArishcentercenterorthoColles’ fracture<br />Colles' fracture:<br />This is a very common injury which affects the distal end of the radius. It was first described by Abraham Colles in 1814 who reported a transverse fracture of the radius, within 1 inch of the wrist, and with dorsal displacement and dorsal angulation of the distal fragment.<br />*The fracture is most common in elderly postmenopausal osteoporotic women who give a history of a fall onto an outstretched hand.<br />1)clinical features:<br /> Classically, the fracture presents with a 'dinner fork' deformity of the wrist.<br />There are five components to the deformity:<br />dorsal angulation of the distal fragment.<br />dorsal displacement of the distal fragment.<br />radial deviation of the hand.<br />Supination.<br />proximal impaction.<br />2)complications: <br /> The complications of a Colles' fracture may be:<br /> A)early..<br /> <br /> B)late..<br />A)Early: <br /> Possible early complications include:<br />swelling and pain of the fingers:<br />from an overly tight plaster<br />easily corrected by re-plastering<br />median nerve damage:<br />rare, due to carpal tunnel compression<br />may require decompression<br />Sudek's atrophy:<br />usually restricted to the fingers but may involve the shoulders<br />exercise of the limb helps to prevent it<br />B)Late:<br /> Possible late complications include:<br />mal-union:<br />is common<br />the reduction may have been incomplete or displacement overlooked<br />disability may be minor but unsightly deformity may be more of a problem<br />surgical correction may be indicated.<br />non-union of the ulnar styloid process.<br />rupture of extensor pollicis longus:<br />due to either movement across a sharp edge of bone or if displacement is minimal, probably, ischaemia.<br />usually treated by tendon transfer using one of the extensors of the index finger.<br />stiffness:<br />from inadequate exercise and / or prolonged splintage.<br />may affect the wrist or the shoulder.<br /> Sudeck's atrophy:<br />This is a form of reflex sympathetic dystrophy that may affect the feet or hands after an injury.<br />It is a major cause of disability with only one in five affected patients able to fully resume prior activities. The earlier a diagnosis is made and treatment is commenced the better the prognosis.<br />Aetiology:<br /> The aetiology is uncertain. The most widely accepted theory proposes the existence of an abnormal reflex arc within the sympathetic nervous system.<br />Following trauma there is a transient alteration in the vasomotor tone of the affected region - unduly sustained changes may result in permanent disturbance of the micro- circulation.<br />Local tissue ischaemia leads to acidosis and tissue dystrophy. The acid metabolites may then activate osteoclasts resulting in local osteoporosis.<br />clinical features:<br /> 1) burning pain.<br /> 2) local swelling, redness and warmth, which after some weeks becomes atrophic and pale.<br /> 3) movements of the affected hand or foot are severely restricted.<br /> <br />