Colles fracture

Q: What is the diagnosis? show answer

A: Colles fracture.

Q: What is the mechanism of this fracture and who is typically affected? show answer

A: Most Colles fractures are secondary to a fall on an outstretched hand (FOOSH) with a pronated forearm in dorsiflexion. Although Colles fractures are seen in all age groups and demographics, they particularly common in osteoporotic individuals and as such are most frequently seen in elderly women.

Q: In what position should the wrist be held when a closed reduction is performed? show answer

A: The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation.

Q: What is the descriptive term used for this somewhat malunited fracture? show answer

A: Dinner fork deformity or bayonet deformity.

Q: If a fracture is mal-united resulting in a dinner fork deformity, what functional limitations ensue and what treatment options exist? show answer

A: In many instances the deformity is merely cosmetically unappealing, although limitation of wrist movement and pronation / supination may also be present. As a result in many cases, especially as the affected population is predominantly elderly, nothing needs to be done. If symptoms are severe or deformity distressing then an osteotomy and internal fixation can be performed.