Colles' Fracture

Orthopedics

Clinicals - History

Fact Explanation
limited range of motion and loss of function colles fracture result in displacement and angulation of the distal fragment of the fracture resulting in shortening of the forearm and limitation to the natural movements at the wrist. (1) limited range of motion and loss of function
colles fracture result in displacement and angulation of the distal fragment of the fracture resulting in shortening of the forearm and limitation to the natural movements at the wrist. (1)
numbness in digits in median ditributuion the fracture segment can easily impact on the median nerve or it can get secondary contusions result in the numbness of the secondary area of the arm supplied by it distally. (2) numbness in digits in median ditributuion
the fracture segment can easily impact on the median nerve or it can get secondary contusions result in the numbness of the secondary area of the arm supplied by it distally. (2)
common in females in females with aging due to hormonal changes there is a reduction in bone mass which result in osteoporotic fractures and also increase the frequency of the falls (3) common in females
in females with aging due to hormonal changes there is a reduction in bone mass which result in osteoporotic fractures and also increase the frequency of the falls (3)
age 35-39 and 60-64 in young people mostly due to orientation of falls and the protective response to falls(fall from outstretched hand)and in old people it is mostly due to post menapausal changes resulting osteoporosis (3,4) age 35-39 and 60-64
in young people mostly due to orientation of falls and the protective response to falls(fall from outstretched hand)and in old people it is mostly due to post menapausal changes resulting osteoporosis (3,4)
osteoporosis primary osteoporosis is mostly due to osteogenesis imperfecta where there is an increase in bone fragility due to collagen defect and secondaries due to endocrine abnormalities ,chronic diseases. (5) osteoporosis
primary osteoporosis is mostly due to osteogenesis imperfecta where there is an increase in bone fragility due to collagen defect and secondaries due to endocrine abnormalities ,chronic diseases. (5)
history of fall traumatic colles fractures are commonly seen with a history of fallen outstretched hand (1) history of fall
traumatic colles fractures are commonly seen with a history of fallen outstretched hand (1)

Clinicals - Examination

Fact Explanation
radial shortening radial shortening is due to dorsal and proximal displacement of the distal fracture fragment(1) radial shortening
radial shortening is due to dorsal and proximal displacement of the distal fracture fragment(1)
silver folk deformity distal fragment of the radius is tilting backward where posterior and laterally displaced (2) silver folk deformity
distal fragment of the radius is tilting backward where posterior and laterally displaced (2)
radial and ulnar styloid processes felt at same level on examination it is due to tearing the tip of the styloid process where normally the radial styloid is more diatal than ulnar(2) radial and ulnar styloid processes felt at same level on examination
it is due to tearing the tip of the styloid process where normally the radial styloid is more diatal than ulnar(2)
broadening of the wrist due to tearing loose of radio ulnar ligaments there is instability in the wrist joint(2) broadening of the wrist
due to tearing loose of radio ulnar ligaments there is instability in the wrist joint(2)
local swelling and redness in general examonation local swelling and pain is due to the sprain or the rupture of the internal lateral ligaments of the wrist.(3) local swelling and redness in general examonation
local swelling and pain is due to the sprain or the rupture of the internal lateral ligaments of the wrist.(3)

Investigations - Diagnosis

Fact Explanation
x ray lateral x ray shows the fracture lineproximal to radioulnar joint , proximally displaced distal fragment of the radius , and prominent callus overlying the fracture site and also other adjust fracture such in ulnar styloid and capal bones (1) x ray lateral
x ray shows the fracture lineproximal to radioulnar joint , proximally displaced distal fragment of the radius , and prominent callus overlying the fracture site and also other adjust fracture such in ulnar styloid and capal bones (1)
MRI its a reliable method of detecting the fracture when the standard x ray films are not dignostic and its also help to diagnose associated or in a doubt to differentiate scaphoid fractures where initial xrays are normal.(3) MRI
its a reliable method of detecting the fracture when the standard x ray films are not dignostic and its also help to diagnose associated or in a doubt to differentiate scaphoid fractures where initial xrays are normal.(3)
Bone scan this is highly sensitive in first 24 hours to detect associated adjust fractures as well (2) Bone scan
this is highly sensitive in first 24 hours to detect associated adjust fractures as well (2)

Investigations - Management

Fact Explanation
full blood count Hb level is checked before giving general anaesthesia as a baseline investigation (1) full blood count
Hb level is checked before giving general anaesthesia as a baseline investigation (1)
ECG to assess baseline cardiao respiratory reserve before anaesthesia (1) ECG
to assess baseline cardiao respiratory reserve before anaesthesia (1)
fasting blood sugar to assess the diabetic control as base line investigation for surgery (1) fasting blood sugar
to assess the diabetic control as base line investigation for surgery (1)
serum electrolytes assess the renal function (1) serum electrolytes
assess the renal function (1)

Management - Supportive

Fact Explanation
2% lignocaine 5ml manipulation under anaesthesia is done by hematoma block where local infiltration of lidnocaine to dorsally in to hematoma. it also helps to reduce the pain(1) 2% lignocaine 5ml
manipulation under anaesthesia is done by hematoma block where local infiltration of lidnocaine to dorsally in to hematoma. it also helps to reduce the pain(1)
conservative management with Closed reduction and cast immobilization minimally displaced and stable fractures or for people who considered too frail to undergo surgery colles pop cast is applied and it removes after 6 weeks (4) conservative management with Closed reduction and cast immobilization
minimally displaced and stable fractures or for people who considered too frail to undergo surgery colles pop cast is applied and it removes after 6 weeks (4)
monitor the distal circulation monitor the circulation by capillary refilling time ,pallor is important after the cast is applied which result in vascular compromise(4). monitor the distal circulation
monitor the circulation by capillary refilling time ,pallor is important after the cast is applied which result in vascular compromise(4).
put ice pack to injured area pain and the inflammation is reduce using the ice pack.(3) put ice pack to injured area
pain and the inflammation is reduce using the ice pack.(3)
splinting splinting help as a immediate management as protection by take the weight off the joint(3) splinting
splinting help as a immediate management as protection by take the weight off the joint(3)
bandaging Compression of the swollen area using bandage will help to reduce the swelling and control the spread into uninjured areas(3) bandaging
Compression of the swollen area using bandage will help to reduce the swelling and control the spread into uninjured areas(3)
limb elevation it reduces the blood flow to the area and minimize the swelling (3) limb elevation
it reduces the blood flow to the area and minimize the swelling (3)
Rehabilitation occupational therapy with active joint exercises to wrist elbow and shoulder
edema prevention and joint strengthening.early mobilization is important to prevent joint stiffness. (2)
Rehabilitation
occupational therapy with active joint exercises to wrist elbow and shoulder
edema prevention and joint strengthening.early mobilization is important to prevent joint stiffness. (2)

Management - Specific

Fact Explanation
intra-medullary K-wire fixation stabilize the distal radius and prevention of secondary displacement of distal radial fractures , k wires are inserted to intramedullary canal manually.(1) intra-medullary K-wire fixation
stabilize the distal radius and prevention of secondary displacement of distal radial fractures , k wires are inserted to intramedullary canal manually.(1)
internal fixation fixed angle locking screws bare applied to achieve anatomical reduction, and in establishing stable fixation to allow perfect reduction ,early range of motion and early rehabilitation compared to external fixation.but it creates more surgical trauma , increase the operation time and the risk of superficial wound infections.it is done using local intravenous infiltration of anesthesia mostly in elderly patient who failed to under go GA and more time consuming.(2,3,4) internal fixation
fixed angle locking screws bare applied to achieve anatomical reduction, and in establishing stable fixation to allow perfect reduction ,early range of motion and early rehabilitation compared to external fixation.but it creates more surgical trauma , increase the operation time and the risk of superficial wound infections.it is done using local intravenous infiltration of anesthesia mostly in elderly patient who failed to under go GA and more time consuming.(2,3,4)
External fixation for treating complex fractures of the distal radius where pins are insert in to distal fragment of radius or 2nd metacarpal bone.But it creates more post operative surgical complications and pin track infections (2,3) External fixation
for treating complex fractures of the distal radius where pins are insert in to distal fragment of radius or 2nd metacarpal bone.But it creates more post operative surgical complications and pin track infections (2,3)

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