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Colles fracture
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Colles fracture

Contributors: Michelle Richardson, Danielle Wilbur MD
Other Resources UpToDate PubMed

Synopsis

Causes / typical injury mechanism: Colles fracture describes an extra-articular distal radius fracture that occurs around 2-3 cm proximal to the radiocarpal joint and is associated with an ulnar styloid fracture. These fractures typically result from a low-energy fall onto an outstretched hand (FOOSH). Falling onto an extended wrist with the forearm in pronation can result in a dorsally displaced, extra-articular distal radius fracture fragment.

Classic history and presentation: Patients with a Colles fracture typically present with recent history of a FOOSH. There is tenderness localized to the distal radius and over the ulnar styloid. Swelling may or may not be present depending on the timing of the injury. A visible deformity may be present in more severe cases. A classic appearance of Colles fracture is known as the "dinner-fork" or "bayonet" appearance, with dorsal displacement of the distal fragment.

Prevalence: Distal radius fractures are one of the most common orthopedic injuries. They account for up to 20% of fractures in the skeletally mature adult population. Up to 9% of individuals are impacted by distal radius fractures by age 90.
  • Age – Prevalence of Colles fractures increases with age.
  • Sex / gender – Women are more commonly affected than men. The lifetime risk of distal radius fracture is reported to be 15% in women by age 50, whereas the risk for men is around 4%.
Risk factors:
  • Older age
  • Female sex
  • Decreased bone mineral density
  • History of recurrent falls
  • History of a previous fracture after age 50
Pathophysiology: Colles fracture typically occurs from a FOOSH. An extended wrist and pronated forearm at the time of impact results in a dorsal displacement of an extra-articular distal fragment. Depending on the severity of the displacement, neurovascular structures may be injured.

Grade / classification system: There are many classification systems that are used to stratify distal radius fractures including the Frykman, AO, Melone, and Fernandez classifications. Most classifications focus on extra- versus intra-articular involvement, degree of displacement, presence / absence of ulnar styloid fracture, and/or distal radioulnar joint (DRUJ) involvement.

Codes

ICD10CM:
S52.539A – Colles' fracture of unspecified radius, initial encounter for closed fracture

SNOMEDCT:
123971006 – Colles' fracture

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Other fractures:
Injury to nearby structures:
  • Scapholunate ligament
  • Lunotriquetral ligament
  • Triangular fibrocartilage complex injury (TFCC)
Injury to the DRUJ

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:04/03/2022
Last Updated:04/19/2022
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Colles fracture
Copyright © 2022 VisualDx®. All rights reserved.