COLLES’ FRACTURE

FIRST DESCRIBED BY

ABRAHAM COLLES IN 1814

 DEFINITION

FRACTURE AT THE DISTAL END OF RADIUS

AT ITS CORTICO-CANCELLOUS JUNCTION

ABOUT 2 CM FROM THE DISTAL ARTICULAR

SURFACE OCCURING IN OSTEOPOROTIC BONE.

MECHANISM OF INJURY
FALL ON AN OUTSTRETCHED HAND WITH

DORSIFLEXION RANGING FROM 400 TO 900

CLASSIFICATIONS
 UNIVERSAL CLASSIFICATION OF DISTAL RADIAL FRACTURES

CLASSIFICATION DESCRIPTION
I NONARTICULAR, NONDISPLACED

II NONARTICULAR, DISPLACED
A REDUCIBLE, STABLE
B REDUCIBLE, UNSTABLE
C IRREDUCIBLE

III ARTICULAR, NONDISPLACED

IV ARTICULAR, DISPLACED

A
REDUCIBLE, STABLE
B REDUCIBLE, UNSTABLE
C IRREDUCIBLE
D
AO CLASSIFICATION OF COLLES FRACTURE
TYPE DESCRIPTION

A EXTRA-ARTICULAR

B PARTIAL ARTICULAR

C COMPLETE ARTICULAR

1 SIMPLE ARTICULAR & METAPHYSEAL #

2 SIMPLE ARTICULAR WITH COMPLEX METAPHYSEAL #

3 COMPLEX ARTICULAR & METAPHYSEAL #

 FRYKMAN CLASSIFICATION OF COLLES FRACTURE
TYPE RADIUS ULNA RADIOCARPAL RADIOULNAR

I EXTRAARTICULAR ABSENT ABSENT ABSENT

II EXTRAARTICULAR PRESENT ABSENT ABSENT

III INTRAARTICULAR ABSENT PRESENT ABSENT

IV INTRAARTICULAR PRESENT PRESENT ABSENT

V INTRAARTICULAR ABSENT ABSENT PRESENT

VI INTRAARTICULAR PRESENT ABSENT PRESENT

VII INTRAARTICULAR ABSENT PRESENT PRESENT

VIII INTRAARTICULAR PRESENT PRESENT PRESENT

PATHOANATOMY
 DISPLACEMENTS
 IMPACTION OF FRAGMENTS

 DORSAL DISPLACEMENT

 DORSAL TILT

 LATERAL DISPLACEMENT

 LATERAL TILT

 SUPINATION
 INJURIES
FRACTURE OF STYLOID PROCESS OF ULNA

RUPTURE OF ULNAR COLLATERAL LIGAMENT

RUPTURE OF TRIANGULAR CARTILAGE OF ULNA

RUPTURE OF INTEROSSEOUS RADIOULNAR

LIGAMENT PRODUCING RADIOULNAR
DISLOCATION
 SYMPTOMS
 PAIN

 SWELLING

 DEFORMITY
 SIGNS
 TENDERNESS

 IRREGULARITY OF LOWER END OF RADIUS

 DINNER FORK DEFORMITY

 ULNAR & RADIAL STYLOID AT THE SAME LEVEL

DINNER FORK DEFORMITY
DINNER FORK DEFORMITY
 RADIOLOGICAL FEATURES
 LATERAL VIEW:- DORSAL TILT

 AP VIEW:- LATERAL TILT

LATERAL VIEW
AP
VIEW
TREATMENT
 UNDISPLACED
- IMMOBILISATION IN BELOW ELBOW
PLASTER CAST FOR 6 WEEKS

 DISPLACED
- MANIPULATIVE REDUCTION &
IMMOBILISATION IN COLLES CAST

 COMMUNITED FRACTURE
- SHORT EXTERNAL FIXATOR
OR
JESS FIXATOR
COLLES CAST
COMPLICATIONS
A. MALUNION

B. STIFFNESS OF JOINTS

C. SUBLUXATION OF INFERIOR RADIOULNAR

JOINT

D. CARPAL TUNNEL SYNDROME

E. SUDECK’S OSTEODYSTROPHY

F. RUPTURE OF EXTENSOR POLLICIS TENDON

THANK YOU