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Colles Fracture

Colles fracture refers to a fracture of the wrist which involves the distal end of the radius of the bone in the forearm. It occurs about an inch from the wrist joint. The fracture occurs diagonally just over the wrist joint and causes the distal end of the bone to display more dorsally, which in turn gives the wrist the classical deformity appearance of a dinner fork.

Colles fracture gets its name from the Irish surgeon who first noted the symptoms of the condition, namely Abraham Colles. The fracture is also referred to by another name, i.e. ‘Pouteau’ fracture. A majority of Colles fracture cases are caused due to a ‘slip and fall’ accident on a stretched out hand.

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The incidence of Colles fracture generally increases after the first snow fall of winter or after the rains when the roads become slippery or icy. In most cases, individuals who slip and fall tend to break the fall by stretching out the hand so that it hits the ground first. Most of us do this to prevent injury to the head or other body parts. In case the fall is a bad one, then it can result in a wrist fracture along with a wound or a bruise on the skin present above the wrist.The bone is a hard living tissue and consists of nerves and blood vessels. This is the reason why a Colles fracture can be extremely painful.

Colles fracture tends to affect people of all age groups. However, it is more commonly observed in two major age groups, i.e. in children and the elderly. The bones of children are supple and soft and hence have a tendency to bend easily, which results in an incomplete Colles fracture. Adults generally suffer from a complete Colles fracture. Such fractures can also be commonly seen in menopausal women afflicted by osteoporosis.

One of the major complications of a Colles fracture is wrist arthritis. It can be caused due to wear and tear of the joints after healing of the fracture, or due to injury to cartilage. Patients may also suffer from carpel tunnel syndrome after a case of Colles fracture.

Symptoms of Colles fracture

In the olden days, the term Colles fracture was used to define a fracture occurring at the cortico-cancellous junction near the distal end of the radius. However, it is currently used to label any kind of fracture of the distal radius which elicits a dorsal dislocation of the fracture pieces and which may or may not affect the ulna.

In fact the surgeon Colles has also defined Colles fracture as one which occurs about 38mm or an inch and a half over the carpal end of the radius, and wherein the lower end of the metacarpus and the carpus seem to be displaced backwards.

A typical Colles fracture has the following symptoms:

  • 0.98 inches or 2.5 cm proximal to the carpal-radio joint
  • Diagonal fracture of the radius
  • Dorsal dislocation and apex volar angulation

An extreme case of Colles fracture may elicit a bayonet-like dislocation

Causes of Colles fracture

Most cases of Colles fracture are caused due to individuals falling onto a concrete or hard surface and breaking such a fall with stretched our arms. People who fall with flexed wrists are more likely to suffer from Smith’s fracture. Colles fracture can also be caused due to overuse of the affected arm.

The fracture was originally diagnosed only in the post-menopausal women and the older adults. It typically affects the area about 3 to 5 centimeters proximal to the carpal-radio joint with lateral and posterior dislocation or the distal bone fragment leading to the formation of a typical bayonet or dinner fork like deformity. Colles fracture also widely affects patients of osteoporosis.

  • Colles fracture can affect people of all ages. However, some patterns are isolated to a particular age group.
  • Younger people generally need a larger force of energy to cause Colles fracture. They also have a tendency to experience more complicated intra-articular fractures. Children affected by open epiphyses can also suffer from an equivalent kind of fracture like a slipped capital femoral epiphysis which occurs in the hip.
  • The elderly or older adults have a weaker cortex and hence they suffer from more extra-articular Colles fractures.
  • Post-menopausal women suffering from osteoporosis are also at greater risk to Colles fractures.

Treatment of Colles fracture

Colles fracture can be treated in a number of ways. After diagnosis the doctor will decide on the correct course of treatment.

  • Less severe cases of Colles fracture can usually be treated with the application of a cast and immobilization. Patients will need to follow certain precautionary measures during the healing process
  • Extreme cases of Colles fracture may require corrective surgery. Patients will need to undergo rehabilitation after such surgery.
  • Treatment of Colles fracture in the elderly differ as per individual cases.
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