Presentation
Patient with history of fall on outstretched hand. Presents with tenderness at the wrist with restricted range of motion.
Patient Data
There is a minimally displaced fracture through the distal radial metaphyseal region with dorsal angulation of the distal fracture component, in keeping with a Colles' fracture.
A suspicion of cortical discontinuity is also seen along the articular surface of the distal radius, which may represent an intra-articular component (extension) of the fracture line.
Unfortunately, CT correlation is not available for the case to confirm this.
Note also the displaced fracture of the styloid process of the distal ulna in this study, as well as surrounding soft tissue swelling.
Case Discussion
Known classically to present with a 'silver fork' or 'dinner fork' deformity of the distal forearm, a Colles fracture is usually the result of a fall on an outstretched hand (FOOSH).
They are seen more frequently with advancing age and in women with osteoporosis.
This eponym is usually reserved for cases where there is no intra-articular radiocarpal joint extension (that is, an extra-articular fracture) which is uncomplicated and stable. However, this is not strictly true and may also be used with some intra-articular fractures.
Always look for signs of instability including intra-articular (radiocarpal distal radioulnar joint) extension, loss of normal radial inclination and radial shortening.