Colle's fracture: Diagnosis and Complications

It is the most common wrist fracture which usually follows a fall on outstretched hand. The fracture occurs within 1 inch of the distal end of the commonest fractures of middle and old age (common in osteoporotic bone). The fracture occurs at cortico-cancellous junction of the bone.

Clinical features:

1. Swelling, ecchymosis, tenderness
2. "Dinner fork" deformity
3. Assess neurovascular status (carpal tunnel syndrome)

X-ray: Distal fragment is -

1. Dorsally displaced and dorsally tilted
2. Radially displaced and radially tilted
3. Supinated
4. Impacted
5. Shortened (radial styloid normally 1cm distal to ulna)
6. +/- fracture of ulnar styloid

Complications:

1. Median nerve injury
2. Malunion
3. Rupture of extensor pollicis tendon
4. Complex regional pain syndrome