Colles’ Fracture

Department Shalya Tantra

By Dr Kiran Khandare
 Contents
• Introduction to Colles’ Fracture
• Relavant Anatomy
• Patho-Anatomy
• Clinical Features
• Treatment
• Complications
 Introduction

• Fracture at the distal end of the radius at its cortico-

cancellous junction

• Commonest fracture in people above 40 yrs of age

• Particularly common in women because of post

menopausal osteoporosis

• Nearly always results from a

fall on an out-stretched hand (FOOSH)
 Relevant Anatomy

• Distal end of radius articulates with the Carpal bones

and the distal end of Ulna

• Normally the distal articular surface of the radius

faces ventrallyand medially

• The tip of the radial styloid is

about 1 cm distal to the tip of ulnar
styloid
 Patho-Anatomy

• The fracture line runs transversely at the cortico-

cancellous junction.
• In majority of the cases displacements seen in Colles’
Fracture
- Impaction of Fragments
- Dorsal displacement
- Dorsal tilt
- Lateral displacement
- Lateral tilt
- Supination
• Some of the following injuries are commonly
associated with –

- Fracture of styloid process of the ulna

- Rupture of the ulnar collateral ligament
- Rupture of the triangular cartillage of the ulna
- Rupture of the interosseous radio ulnar ligament
producing radio ulnar subluxation
 Clinical Features

• Patient presents with

- Pain
- Swelling
- Deformity of Wrist

• On examination
- Tenderness
- Irregularity of the lower end of
radius
- Dinner fork deformity
 Treatment

• Undisplaced fracture – immobilisation in a below-

elbow plaster cast for 6 weeks is sufficient.

• Displaced fracture – Manipulative reduction followed

by immobilisation in Colles’ cast
 Technique of Manipulation
• Muscles of forearm must be relaxed, either by
Regional anaesthesia or GA

• Grasp the injured hand as if shaking hand

• Disimpact the fragment – achieved by firm

longitudinal traction to the hand against the counter –
traction by an assistant who grasp the arm above
flexed elbow
• Then surgeon presses the distal fragment into palmer
flexor and ulnar deviation using thumb

• Patient’s hand is drawn into pronation, palmar flexion

and ulnar deviation

• Plaster cast Is applied extending from below the

elbow to the metacarpal heads, maintaining wrist in
palmar flexion and ulnar deviation – Colles’cast
• Check X-ray every week for
first 3 weeks in order to detect
redisplacement

• Plaster removed after 6 weeks and joint – mobilising

and muscle strengthening exercises should be started

• In case of redisplacement percutaneous transfixation

is done using 2 K-wires
 Complications

• Stiffness of joints
• Mal-union
• Subluxation of the inferior radio-ulnar joint
• Carpal-tunnel syndrome
• Sudeck’s oesteodystrophy
• Rupture of the extensor pollicis longus tendon
Thank You