• describe by : - Abraham colle`s - 1814.
Definition : - it is not just fracture lower end of
radius but a fracture dislocation of the inferior
radioulnar joint .
• Occurs about 2.5 cm above the carpal extremity of
the radius .
Commonest age group- Elderly.( 60 yrs)
MOA – fall in outstretched hand.
• Force required to cause this fracture is 192 kg in
women and 282 kg in men.
Clinical features.• Swelling.
• Dinner fork defomity, it is not found in all cases
but seen only if there is a dorsal tilt or rotation of
the distal fragment
ExaminationDistal neurovascular status.
dorsal displacement of the distal
Styloid process test :
• Normally , the radial styloid proces is lower by
1.3 cm when compaired to the ulnar styloid
• In colle`s both radial and ulnar styloid
processes are at the same level and are found
in all displacements of colle`s fracture.
• This is more reliable sign than dinner fork
Distance between radial and styloid
• Fig :
X – ray of the wrist : • AP and lateral views and lower end of the
Displacement in a colle`s fracture :
• Dorsal displacement
• Dorsal rotation
• Lateral displacement
• Lateral rotation
• Conservative methods
• Operative methods
CONSERVATIVE METHODS :
- closed reduction under general anaesthesia (GA),or
local anaesthesia (LA)
- If the level of the styloid processes are restored back
to normal , it indicates that the reduction has been
- limb is immobilised by colle`s cast and a check
radiograph is taken
- Removed after 6 – 8 weeks
It is a below elbow cast in supination and ideally
it has to meet the following 4 criteria :Firm fit at the dorsum
Firm fit at the volar fracture apex
Just snuggly fitting at the forearm
Metacarpophalangeal joints should be free to
Surgical methods :
1 . Closed reduction and percutaneous pinning
with k – wires
2 . Open reduction and plate fixation.
Early complication :
• Unstable reduction
• Medial or ulnar nerve
• Post reduction swelling
• Compartmental syndrome
• Anaesthesia problem
• Injury to proximal segment
of the bone during
Late complication :
• Rupture of extensor pollicis
• Frozen shoulder
• Carpel tunnel syndrome
• Sudeck`s osteodystrophy
COLLE`S FRACTURE Why is it called fracture of 6…?
• Common at 60 years
• Force required to cause colle`s fracture are
multiples of 6
• 6 classical displacements
• 6 method of fracture immobilisation
• 6 important early and late complications
• 60 per cent cases have fracture ulnar styloid
• Reverse of colle’s fracture.
• Wrist fracture in which the distal end of the radius
is displaced forwards.
Mechanism of injury :
• Fall on the back of the dorsum of the hand
• Fall on the forearm in supination
• Direct blow to the flexed hand
Clinical features : •
Loss of wrist function
Deformity is opposite to that of colle`s
fracture and is called the garden shaped
Radiography : • AP view of the wrist
• Complication of colle`s
Treatment : • Closed reduction and immobilisation in a long
arm cast with forearm in supination and wrist
Unstable fractures : • Fixation with k – wire or open reduction and