fracture of distal radius
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FRACTURE OF DISTAL RADIUS
NUR HANISAH BINTI ZAINOREN
ANATOMY
TYPES
1. COLLES’ FRACTURE2. SMITH’S FRACTURE3. BARTON’S FRACTURE
COLLES’ FRACTURE
• Fracture at the distal end of the radius, at its cortico-cancellous junction, with dorsal tilt and other displacements, in an osteoporotic bone
Other displacements (1/> displacements below occur in majority of the cases; although in few cases it may be crack fracture without displacement)
o Impaction of fragmentsoDorsal displacementoDorsal tilto Lateral displacemento Lateral tilto Supination
Injuries associated with Colles’ fracture:
o Fracture of the styloid process of the ulnaoRupture of the ulnar collateral ligamentoRupture of the triangular cartilage of the ulnaoRupture of the interosseous radio-ulnar ligament,
causing radioulnar subluxation
Clinical features:
oPaino SwellingoDeformity of the wristoOn examination;
Tenderness Irregularity of the lower
end of radius
Radiological features: (Differentiated from other fractures at the same site by looking at the displacements)
oDorsal tilt can be detected on a lateral X-ray:
normal faces ventrally dorsal tilt faces dorsally or
becomes neutral
o Lateral tilt can be detected on an AP X-ray:
normal faces medially lateral tilt faces laterally or
becomes horizontal
Treatment:
oUndisplaced fracture immobilization in a below-elbow plaster cast for 6 weeks
oDisplaced fracture manipulative reduction followed by immobilization in Colles’ cast
Complications:1. Stiffness of joints2. Malunion3. Subluxation of the inferior radio-ulnar joint4. Carpal tunnel syndrome5. Sudeck’s osteodystrophy6. Rupture of the extensor pollicis longus tendon
SMITH’S FRACTURE
• Fracture at the distal end of the radius, at its cortico-cancellous junction, with ventral tilt and other displacements
• Uncommon
• Treatment:• Closed reduction • Plaster cast immobilization (6
weeks)
BARTON’S FRACTURE
• Intra-articular fracture of the distal radius
• Extends from the articular surface of the radius to either its anterior/posterior cortices
• The small distal fragments gets displaced and carries with it, the carpals
• Displacements:• Volar Barton’s fracture
(anterior type)• Dorsal Barton’s fracture
(posterior type)
• Treatment:• Closed manipulation • ORIF with plate in cases
where closed reduction fails
REFERENCE
• Essential Orthopaedics, 4th Edition, Maheshwari & Mhaskar, JAYPEE
Thank you
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