Ask your doctor if you can take them for pain relief. NSAIDs can help with pain but might also hamper bone healing, especially if used long-term. If your pain is severe, you might need an opioid medication, such as codeine. To reduce pain, your doctor might recommend an over-the-counter pain reliever. You'll be advised to keep your hand above heart level as much as possible to reduce swelling and pain. To do this, you'll likely need a splint or a cast. Restricting the movement of a broken bone in your wrist is critical to proper healing. Smoking can delay or prevent bone healing. Ask your doctor about the best ways to move them. Whatever your treatment, it's important to move your fingers regularly while the fracture is healing to keep them from stiffening. Depending on the amount of pain and swelling you have, you might need a local or general anesthetic before this procedure. Your doctor will need to manipulate the pieces back into position, a procedure known as a reduction. Originally named by Abraham Colles (1773-1843), an Irish surgeon.If the broken ends of the bone aren't aligned properly, there can be gaps between the pieces of bone or fragments might overlap. Secondary osteoarthritis: more frequently seen in patients with intra-articular involvementĮxtensor pollicis longus tendon tear: more common in non-displaced fractures 5 Median nerve palsy and post-traumatic carpal tunnel syndrome Malunion resulting in dinner fork deformity >10 degrees dorsal angulation >5 mm shortening significant comminution) 1. Open reduction and internal fixation (ORIF) is considered when the fracture is unstable, and/or unsatisfactory closed reduction is achieved (i.e. The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation 4 - for those of you familiar with Australian rules football this position is reminiscent of the position adopted when holding a ball in preparation for a kick. The vast majority of Colles fractures can be treated with closed reduction and cast immobilization. Location of the medial fracture line: does it involve the radioulnar joint In addition to noting the presence of a fracture a number of features should be sought and commented upon: An associated ulnar styloid fracture is present in up to 50% of cases.Ī pronator quadratus sign is generally seen. If dorsal angulation is severe enough, a dinner fork deformity may be described.There is also usually impaction with resultant shortening of the radius. Dorsal angulation of the distal fracture fragment is present to a variable degree (as opposed to volar angulation of a Smith fracture). The fracture appears extra-articular and usually proximal to the radioulnar joint. The plain radiographic series often comprises an AP and a lateral view however, it is not uncommon for an oblique view to be included. Plain films usually suffice, although if there is a concern of intra-articular extension, then CT may be beneficial. As such, in clinical practice, the use of the term Colles fracture with an appropriate description of any associated injuries is sufficient in most instances. One of the more popular is the Frykman classification system, although it fails to distinguish between Smith and Colles fractures as it is based on AP radiographs 2,3. Radiographic featuresĪ number of classification systems exist for distal forearm fractures. Most fractures are therefore dorsally angulated and impacted. The proximal row of the carpus (particularly the lunate and scaphoid) transfers energy to the distal radius, both in the dorsal direction and along the long axis of the radius. Most Colles fractures are secondary to a fall on an outstretched hand (FOOSH) with a pronated forearm in wrist extension (the position one adopts when trying to break a forward fall). during contact sports, skiing, horse riding 1. Younger patients who sustain Colles fractures have usually been involved in high impact trauma or have fallen, e.g. The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated 1. They are particularly common in patients with osteoporosis, and as such, they are most frequently seen in elderly women. Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics.
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