Colles' Fracture Radiography

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Introduction

The Colles' fracture is one of the most common fractures seen by radiographers. The subtle Colles' fracture is also a commonly missed fracture. This page considers all aspects of Imaging Colles fractures.

Eponym

"The Colles' fracture is named after Abraham Colles (1773-1843), an Irish surgeon who first described this in 1814 before the advent of X-rays." <a class="external" href="http://en.wikipedia.org/wiki/Colles%27_fracture" rel="nofollow" target="_blank">(http://en.wikipedia.org/wiki/Colles%27_fracture)</a>. The term Colles' fracture strictly refers to a dorsally angulated fracture of the distal radius. The modern useage of the term tends to refer to all distal radius fractures.

Sex and Age Distribution

This is the commonest wrist fracture & often occurs in postmenopausal women.

Mechanism of Injury

Colles' fractures are typically caused by a fall onto an outstretched hand.

Fracture Description

It usually results from a fall onto the outstretched hand & leads to the Radius crushing into itself (impaction) & tilting backwards (dorsal angulation). A Colles fracture results in the radius shortening or conversely the ulna becomes too long and impacts against the carpal bones. Normally the radius is tilted forward approx. 10 degrees on a side view (10 degrees palmar tilt) <a class="external" href="http://www.myhand.com.au/index.php?option=com_content&view=article&id=74:colles-fracture&catid=52:wrist&Itemid=114" rel="nofollow" target="_blank">(Dr Stuart Meyers)</a>. The strict definition of Colles' Fracture (and other eponyms) has become bluured and, becuase of this, many radiologists prefer not to use any eponyms when describing farctures. For what it's worth, the following is one authors interpretatio n of te definitioon of Colles'Fracture

	Colles fractures are dorsally angulated fractures of the distal radius that are extra articular and less than 2.5 cm from the wrist joint. When the fracture involves the radiocarpal joint or the distal radioulnar joint they are not strictly Colles fractures. Volarly angulated fractures are called Smiths and Barton's fractures.
	<a class="external" href="http://www.orthospot.com.au/papers.orthospot.com.au/fracupl_files/frame.htm" rel="nofollow" target="_blank">http://www.orthospot.com.au/papers.orthospot.com.au/fracupl_files/frame.htm</a>

Clinical Presentation

	Patient with Colles' fracture demonstrating a typical dorsally angled deformity commonly referred to as a 'dinner fork' deformity
	Patient with Colles' fracture demonstrating a typical dorsally angled deformity commonly referred to as a 'dinner fork' deformity