Musculoskeletal Imaging

Colles' fracture

(Abraham Colles, 1773 - 1843, Irish surgeon), a transverse fracture that extends from the volar to the dorsal surface of the distal end of the radius. This injury is accompanied by impaction and displacement of the dorsal radial surface (Fig.1). A concomitant fracture of the ulnar styloid process is frequently seen. Shortening of the radius and dorsal inclination of its articular surface occur with Colles' fractures. Complications of Colles' fractures include unstable reduction, incongruity of joints, subluxation of the distal radioulnar joint, compression of the median nerve, ulnar nerve injury, entrapment of flexor tendons, reflex sympathetic dystrophy, carpal malalignment and nonunion.

A fracture of the distal end of the radius similar to that of the Colles' fracture but with volar rather than dorsal angulation or displacement of the distal fragment is known as Smiths fracture.

Colles' fracture, Table 1. Characteristics and complications of Colles' fracture.

 

Characteristics
Fracture of distal portion of radius with dorsal displacement
Classification system based on extraarticular versus intraarticular location, presence or absence of ulnar fracture
Varying amounts of radial displacement, angulation and shortening
Ulnar styloid f racture in about 50 60% of cases
Associated injuries to carpus, elbow, humerus, femur (in osteoporotic patients) and inferior radioulnar joint
Complications
Deformity related to radial shorterning and angulation
Subluxation or dislocation of inferior radioulnar joint
Reflex sympathetic dystrophy
Injury to median, radial or ulnar nerve
Osteoarthritis
Tendon rupture

 

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Fig.1

Lateral radiograph demonstrates a fracture of the distal radius with dorsal angulation and displacement of the distal fracture fragment.
Colles' fracture, Fig.1