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. 2007 May 3;125(3):132-8.
doi: 10.1590/s1516-31802007000300002.

Fractures of the distal radius (Colles' fracture)

João Carlos Belloti  1 , João Baptista Gomes dos Santos, Alvaro Nagib Atallah, Walter Manna Albertoni, Flavio Faloppa
Affiliations

Fractures of the distal radius (Colles' fracture)

João Carlos Belloti et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context and objective: Although Colles' fracture is a common clinical situation for the orthopedist, we did not find any information in the literature that would allow safe decision-making on the best treatment for each fracture type. The aim of the present study was to investigate Brazilian orthopedists' opinions regarding the main aspects of treatments for Colles' fracture.

Design and setting: Cross-sectional study conducted during the 34th Brazilian Congress of Orthopedics and Traumatology.

Methods: Five hundred questionnaires containing 12 items were randomly distributed to orthopedists who were attending the congress; 439 were filled out correctly and were considered in this study.

Results: The main factors in making decisions on interventions in fracture cases were whether the fracture was intra-articular, the existence of shortening of the distal radius and the patient's age. The classification method most used was Frykmann. The closed reduction method most used was manual reduction. The principal surgical interventions were percutaneous pinning (39%), external fixation (27%) and volar plate (19%). Most of the interviewees only used bone grafts for osseous gaps in special cases. The most frequent complications were impairment of joint mobility and residual pain.

Conclusions: Brazilian orthopedists have concordant opinions regarding conservative treatment methods and the use of bone grafts. There were conflicting opinions regarding surgical treatment methods, classification types and complications.

CONTEXTO E OBJETIVO:: Embora as fraturas de Colles sejam uma situação clínica comum para os ortopedistas, não encontramos na literatura elementos que permitam decidir com segurança sobre a melhor forma de tratamento para cada tipo dessas fraturas. O objetivo deste estudo foi verificar a conduta dos ortopedistas brasileiros quanto aos principais aspectos do tratamento das fraturas de Colles.

TIPO DE ESTUDO E LOCAL:: Estudo transversal, realizado durante o 34o Congresso Brasileiro de Ortopedia e Traumatologia, São Paulo (SP).

MÉTODOS:: 500 questionários, com 12 itens foram distribuídos aleatoriamente aos congressistas, sendo que 439 foram corretamente preenchidos e considerados no estudo.

RESULTADOS:: Os principais fatores para a decisão e opção da forma de tratamento foram o grau de acometimento articular, o encurtamento do rádio e a idade. O método de classificação das fraturas do rádio distal mais utilizada é o de Frikmann. Como métodos cirúrgicos, 39% dos entrevistados utilizam uma das três técnicas de pinagem percutânea, 27% utilizam o fixador externo e 19% utilizam osteossíntese com placa volar. Quanto à utilização de enxerto ósseo, a maioria dos entrevistados somente o utiliza em casos especiais. As complicações mais freqüentes foram a restrição do arco de movimento e a dor residual.

CONCLUSÃO:: A conduta do ortopedista brasileiro é concordante quanto à forma de tratamento conservador e à utilização de enxerto ósseo. Há conflito de opiniões quanto ao método de classificação das fraturas; aos métodos de tratamento cirúrgico e às complicações.

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Conflict of interest statement

Conflicts of interest: Not declared

Figures

Figure 1
Figure 1. Results from question 1, about matters to consider in treatment choice.
Figure 2
Figure 2. Results from question 2, about the classification method used.
Figure 3
Figure 3. Results from question 3, about the preferred conservative method for Colles’ fracture.
Figure 4
Figure 4. Results from question 4, about fracture reduction method.
Figure 5
Figure 5. Results from question 5, about positions for immobilization.
Figure 6
Figure 6. Results from question 6, about the choice of surgical technique.
Figure 7
Figure 7. Results from question 7, about substitution materials for the bone.
Figure 8
Figure 8. Results from question 8, about complications of conservative treatment.
Figure 9
Figure 9. Results from question 9, about complications of surgical treatment.
Figure 10
Figure 10. Results from question 10, about associated injuries.
Figure 11
Figure 11. Results from question 11, about the time until the patient resumes activities with conservative treatment.
Figure 12
Figure 12. Results from question 11, about the time until the patient resumes activities with surgical treatment.
See this image and copyright information in PMC

References

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