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Wrist (Colles’ Fracture (Treatment (non-operative (closed reduction),…
Wrist
Colles’ Fracture
- extra-articular transverse distal radius fracture with dorsal displacement ± ulnar styloid fracture
- most common fracture in those >40 yr, especially in women
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Features
“dinne rfork” deformity, swelling, ecchymoses, tenderness
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Treatment
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operative
- percutaneous pinning, external fixation or ORIF
- indication: failed closed reduction, or loss of reduction
Scaphoid Fracture
- common in young men; not common in children
- most common carpal bone injured
- may be associated with Colles’fracture
- Mechanism: FOOSH
- Features: pain with resisted pronation,
- Investigations:
x-ray: AP, lateral, scaphoid views with wrist extension and ulnar deviation
Scaphoid Fracture Special Tests: Tender snuff box: 100% sensitivity, but 29% specific as positive with many other injuries of radial aspect of wrist with FOOSH
Treatment
- non-operative: long-arm thumb spica cast
- operative: displaced: ORIF
Specific Complications
- most common: non-union/mal-union
- AVN of the proximal fragment
Smith’s Fracture
- volar displacement of the distal radius
- fall on to the back of the flexed hand
- x-ray: AP and lateral wrist
- ORIF