Definition – A Colle’s fracture is a fracture of the radius within 2.5 cms of the wrist with or without avulsion of the ulnar styloid process and with a characteristic deformity. The lower fragment is usually tilted backwards, shifted backwards with a tilt radially. Colle’s fracture is the commonest of all fractures.
Elderly women are more often involved due to osteoporosis. It usually occurs from a fall on the outstretched and dorsiflexed hand and the momentum of the body imposes a supination force which breaks the lower end of the radius transversally.
- Rotational Displacements – Occur on two axis:
- On longitudinal axis, the distal fragment rotates outwards.
- The distal fragment also rotates on a transverse axis.
- Linear Displacement – The whole lower fragment is displaced–
In total, the altered contour of, the wrist due to displaced distal fragment looks like a ‘Dinner-fork deformity.
- Seen mainly in middle-aged and elderly women.
- Osteoporosis is a frequent contributing factor.
- Patient usually presents with a deformed and swollen wrist with gross displacement of the lower fragment.
- Patient often presents with typical ‘Dinner-fork deformity.’
- Tenderness first proximal to the wrist; may feel the deformity on careful palpation.
- Normally the tip of the radial styloid process is situated 1 cm distal to the tip of the ulnar styloid process, but after Colle’s fracture, the tips may be at the same level or even the ulnar one may be lower.
- Wrist movements are limited and painful.
X-ray identifies the fracture in a majority of cases.
- Reduction – In 3 stages :
- Palmar flexion.
- Ulnar deviation.
Reference: A Handbook of Surgery by Dr Mansi Sharma