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forearm
Colle`s and smith`s
fracture
Colles fracture.
Colles fracture
Fig : -
Colles fracture
Fig : -
AP View
Fig : - colle`s fracture
Colles fracture
Fig : -
Frykmann`s classification :
Fracture line
1 .. Extra - articular
2. Intra articular (involving RC
joint only )
Distal ulnar
fracture
Absent
1
3
present
2
4
6
8
Frykmann`s classification
Fig :
Radiograpy :
Treatment :
Conservative methods
Operative methods
CONSERVATIVE METHODS :
- closed reduction under general anaesthesia
(GA),or local anaesthesia (LA)
- If the level of the styloid processes are
restored back to normal , it indicates that the
reduction has been achieved satisfactorily.
- limb is immobilised by colle`s cast and a
check radiograph is taken
- Removed after 6 8 weeks
- physiotherapy
6 immobilisation
method :
Below elbow cast (10 20
degree palmar flexon , 15 20
degree ulnar deviation ) COLLE`S
CAST
ABOVE ELBOW CAST IN
SUPINATION
. ABOVE
ELBOW CAST IN MID- PRONATION
.ABOVE
CAST IN WRIST FULLY
COTTON ELBOW
LODER`S POSITION(
PRONATION
FLEXED)
. EXTERNAL FIXATORS
Colle`s cast
Colle`s cast
Cont..
Fig : -
Surgical methods :
1 . Closed reduction and
percutaneous pinning with k wires
2 . Open reduction and plate fixation.
Complication
Early
complication :
Unstable reduction
Medial or ulnar nerve
stretched
Post reduction swelling
Compartmental syndrome
Anaesthesia problem
Injury to proximal
segment of the bone
during reduction
Late
complication :
Malunion
Rupture of extensor
pollicis tendon
Frozen shoulder
Carpel tunnel syndrome
Nonunion
Sudeck`s
osteodystrophy
Smiths Fracture.
Reverse of colles fracture.
Wrist fracture in which the distal end of
the radius is displaced forwards.
Mechanism of injury :
Fall on the back of the dorsum of the
hand
Fall on the forearm in supination
Direct blow to the flexed hand
Clinical features :
Pain
Swelling
Deformity
Loss of wrist function
Deformity is opposite to that of
colle`s fracture and is called the
garden shaped deformity.
Radiography : AP view of the wrist
Complication :
Complication of colle`s
Treatment : Closed reduction and immobilisation
in a long arm cast with forearm in
supination and wrist in extension.
Unstable fractures : Fixation with k wire or open
reduction and plate fixation.