Colles Fracture

Excerpt

Named after Abraham Colles, who first described a distal radius fracture in 1814 at the Royal College of Surgeons in Dublin, the Colles fracture is one of the most common fractures encountered in orthopedic practice representing 17.5 % (one-sixth) of all adult fractures presenting to the emergency department. The Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture. The term Colles fracture is often used eponymously for distal fractures with dorsal angulation. These distal radius fractures are often caused by falling on an outstretched hand with the wrist in dorsiflexion, causing tension on the volar aspect of the wrist, causing the fracture to extend dorsally.

Anatomy

The distal radius bears 80% of the axial load. It has the following articulations; scaphoid ( scaphoid fossa), lunate ( lunate fossa), and distal ulna ( ulnar or sigmoid notch).

The distal radius has three columns; radial, intermediate and ulnar columns.

The radial column ( radial styloid + scaphoid fossa):

1. It has the attachment of the brachioradialis tendon, long radiolunate ligament, and radioscaphocapitate ligament, which prevents ulnar translation of the carpus.

2. It works as a buttress for radial translation of the carpus and holds it to length radially for even load distribution across the scaphoid and lunate fossae.

3. It acts as a load-bearing strut for wrist ulnar deviation.

The intermediate column (Lunate fossa): is responsible for load transmission from the carpus to the forearm.

The ulnar column ( TFCC + Distal ulna): Stabilizes the DRUJ and forearm rotation.