11/2/2023 0 Comments Dinner fork colles fracture![]() Indications: Extensive comminution, impaction, median nerve entrapment and associated injuries in adults. Operative treatment is rarely required for Colles’ fracture and may be required in the following situations: The common causes for failure of reduction are incomplete reduction of the palmar fracture line and dorsal comminution of the lower end of radius. The plaster cast is removed after 6-’8 weeks and physiotherapy is begun. Then the limb is immobilized by any one of the methods in the table above (mainly Cones’ cast) and a check radiograph is taken. If the level of the styloid processes is restored back to normal, it indicates that the reduction has been achieved satisfactorily. At the end of the procedure, styloid process test is carried out to check the accuracy of reduction. This disimpacts the fracture and the examiner corrects the other displacements of the fracture. With an assistant giving counteraction by holding the forearm or arm of the patient, the examiner gives traction in the line of the forearm. The examiner holds the hand of the patient as if to shake hand. Here fracture reduction is carried out by closed methods under general anesthesia (GA) or local anesthesia (LA). The treatment methods include Conservative methods, Operative methods and External fixators. In the lateral view, the points noted are dorsal displacement and dorsal tilt of the distal fragment, sharp palmar surface and dorsal comminution of the lower end of radius, distal radioulnar joint subluxation, etc.Ĭontrary to popular belief, Colles’ fracture is both intra-articular and extra-articular and not only extra-articular. Frykmann’s classification takes into consideration both and the fracture of ulna.Īim: The aim of treatment is to restore fully functional hand with no residual deformity. ![]() The Points noted in the AP view are metaphyseal comminution, fracture line extending into the radiocarpal or inferior radioulnar joint and fracture of the ulnar styloid process (seen in about 60% of the cases). Radiographs of the wrist both AP and lateral views of the affected wrist and lower end of the radius are taken. Hence, this is a more reliable sign than dinner fork deformity. In Cones’ both radial and ulnar styloid processes are at the same level and are found in all displacements of Colles’ fracture. Normally, the radial styloid process is lower by 1.3cm when compared to the ulnar styloid process. Though dinner fork deformity is a classical deformity in a Colles’ fracture, however, it is not found in all cases but seen only if there is a dorsal tilt or rotation of Colles’ Fracture. The patient complains of pain, swelling, deformity and other usual features of fracture at the lower end of radius. Usually, the patient is an elderly female in her 60s and the history given is a trivial fall on an outstretched hand. The force required to cause this fracture is 192 kg in women and 282 kg in men.įracture pattern: It is usually sharp on the palmar aspect and comminution on the dorsal surface of the lower end of radius. The common mode of injury is fall on an outstretched hand with dorsiflexion ranging from 40-900. ![]() It is not just fracture lower end of radius but a fracture dislocation of the inferior radioulnar joint. The fracture occurs about 11/2″ (about 2.5 cm) above the carpal extremity of the radius.įollowing this fracture, some deformity will remain throughout the life but pain decreases and movements increase gradually. Abraham Colles first described in the year 1814. This is also called as Poutteau’s fracture in many parts of the world.
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