View source for Colles' fracture

==Background==
*Distal radial metaphysis fracture that is dorsally displaced and angulated
**Fracture line may extend into radioulnar or radiocarpal joint ("die-punch" fracture)
*Occurs due to FOOSH
*Ulnar styloid fracture is often present and suggests injury to TFCC

==Clinical Features==
[[File:Colles Fractuur.jpg|thumb|[[Colle's fracture]] on physical exam.]]
*Characteristic dorsiflexion or "dinner-fork" deformity
*Palmar paresthesias (pressure on median nerve)

==Differential Diagnosis==
{{Distal radius fracture DDX}}

==Evaluation==
[[File:Colles fracture.JPG|thumb|Colles fracture]]
[[File:Collesfracture.jpg|thumb|[[Colles' fracture]]]]
===Imaging===
*PA
**Distal metaphyseal fracture that often appears shortened from angulation or comminution
*Lateral
**Provides best view of dorsal angulation and comminution

==Management==
{{General Fracture Management}}

===Specific Management===
*Unstable Fracture - Immediate ortho referral
**>20 degrees angulation
**Intra-articular involvement
**Marked comminution
**>2/3 displacement
**5mm shortening of the radius
*Stable Fracture
**Use [[Procedural sedation]] or [[Hematoma block]]
**Hang 10 lb weight with finger traps or otherwise provide longitudinal traction
**Recreate the injury by extending wrist to 90 degrees while elbow is flexed
**Pull distal segment back, up, and then out; use both thumbs to apply volar pressure 
**Immobilize wrist with [[sugar tong splint]] at 15 degrees of flexion, 20 degrees of ulnar deviation, and slight pronation <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
**Goals for post-reduction X rays: normal radius length, normal radial inclination of 15-30 degrees and volar tilt of 10-15 degrees

==Disposition==
*Outpatient with ortho follow up

==See Also==
*[[Distal radius fractures]]

==References==
<references/>

[[Category:Orthopedics]]