Understanding and management of fractures of distal end of radius have come a long way. Consider this statement by Abraham Colles made two centuries back.
“One consolation remains that limb will , at some remote period enjoy perfect freedom in all its motions, and be completely exempt from pain. The deformity, however will remain undiminished throughout the life.”
Modern management of these fractures have made these statement a history. Much has been understood about complexities of fractures of distal end radius and the management has evolved a lot incuding the techniques and instruments.
Broadly speaking fractures can be either extra-articular or intra articular [Not involving or involving the joints].
What has been described as Colles fracture is an extra-articular fracture of the distal end of radius.
This fracture presets as classical “silver fork” deformity and depending on the degree original displacement, the patient’s age, the patient’s skin turgor, and the patient’s coagulation status, variable swelling is present.
Aprt from Colle’s fracture, fracture of distal end radius may present in various forms. A comprehensive classification will follow this article.
Assciated soft tissue injury can occur. The important soft tissue structures that can injure are scapholunate ligament and triangular fibrocartilage complex.
Condition of the skin, local nerve, vascular and tendon function, and function of the elbow, shoulder, and fingers should be assessed and noted. Examination of forearm rotation should be done, when possible, before and after reduction.
In high-energy or open injuries, damage to nerves, tendons, vessels, and/or skin can occur.
The treatment of these fractures vary with type of fracture, age of the patient, associated soft tissue injury and demand of the patients. While fractures in younger patients demand an aggressive approach, older patients with lesser demand have a high acceptability of conservative treatment.
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