Colles' fracture

Introduction to Coles' fracture Collesfracture refers to a cancellous fracture of the lower end of the humerus. The fracture occurs in the cancellous region within 2 to 3 cm of the lower end of the humerus. It is one of the most common fractures in the human body, accounting for 10% of all fractures. The majority of the elderly and adults are mostly fractured, and the articular surface can be destroyed. The same violence in young people can cause the separation of the lower jaw bones. basic knowledge The proportion of illness: 0.003% Susceptible people: good for the elderly and adults Mode of infection: non-infectious Complications: scaphoid fracture

Cause of Coles' fracture

Violent factors (78%):

Mostly caused by indirect violence. Most of them fall flat, the palms hold the ground, the wrist joints are in the back extension and the forearm internal rotation, so that the violence is concentrated on the cancellous bone of the distal radius and causes the fracture. In this state, the distal end of the fracture must appear to the dorsal side. Displacement of the temporal side, at this time, the ulnar styloid process may be accompanied by a fracture, and the triangular fibrocartilage disc may also tear.

Coles' fracture prevention

1. The disease is caused by traumatic factors, so paying attention to production and life safety is the key to preventing this disease.

2. Strengthen physical exercise, add more calcium, and more sun exposure for calcium absorption.

Coles' fracture complications Complications

1. Injuries are often accompanied by shoulders, elbow joint contusions: plus the pain in the fracture, the activity of the affected limb is reduced, the shoulders of time, the elbow joint will be stiff.

2. Fracture deformity can compress the carpal tunnel: the symptoms of median nerve compression appear, and gradually recover with the correction of the fracture.

3. Abdominal extensor tendon rupture: generally occurs 4 weeks after injury, sometimes later, there are two reasons for the fracture, one is caused by the original injury, the other is the fracture and Lister nodules, the tendon is not smooth The bone surface wears and breaks.

4. Fracture repair or fixation failure: can lead to fracture malformation.

5. Sudeck bone atrophy (reflex sympathetic bone atrophy, post-traumatic bone atrophy) can occur.

6. Can be combined with the scaphoid bone fracture at the same time, should pay attention to the examination, so as not to miss the diagnosis.

Coles' fracture symptoms common symptoms severe pain wrist silver forked deformity wrist gun stabbed deformity comminuted fracture

The patient's wrist stretched down, and the palm of the hand fell to the ground. The wrist felt severe pain, and did not dare to move. The swelling was especially swollen with local swelling. Sometimes the subcutaneous congestion was seen. The finger was in a semi-flexed rest position, and the fist was not allowed to make a fist. The hand can relieve some pain, such as proximal fracture pressure and median nerve, there are signs of median nerve dysfunction such as finger numbness, and the typical signs of Corio fracture are as follows.

Silver forked deformity

The distal end of the fracture, along with the hand, was displaced to the dorsal side with a depression on the proximal side (Fig. 2A).

2. Gun-shaped deformity

The distal end of the fracture is displaced along with the hand to the temporal side, and the axis of the middle finger is not in the same plane as the axis of the tibia (Fig. 2B).

3. Ruler test

Normally, place the ruler on the side of the ulnar, and the ruler of the ulnar stem is more than 1cm. When the lower end of the humerus is fractured, the ulnar styloid can be in contact with the ruler (Fig. 3).

4. Linear relationship between ulnar styloid process and sacral styloid process

After the lower end of the humerus fracture, the ulnar styloid and the sacral styloid process are on the same line. Normally, the sacral styloid process is 1 to 1.5 cm more than the ulnar styloid process.

Fracture classification methods are different. The Frykman classification is widely used. The fractures of the distal radius are classified into 8 categories based on the damage of the articular surface, the injury of the lower ankle joint, and the fracture of the distal end of the ulna.

(1) Extra-articular fractures, no distal ulnar fractures.

(2) Extra-articular fractures, with distal ulnar fractures.

(3) intra-articular fractures, affecting the ankle joint, but no distal ulnar fracture.

(4) intra-articular fractures, affecting the ankle joint, with distal ulnar fracture.

(5) intra-articular fractures, affecting the lower ankle joint, no distal radius fracture.

(6) intra-articular fractures, affecting the lower ankle joint, with distal ulnar fracture.

(7) intra-articular fractures, involving the ankle joint and the lower ankle joint, but no distal ulnar fracture.

(8) intra-articular fractures, involving the ankle joint and the lower ankle joint, with a distal ulnar fracture.

Examination of the Coles' fracture

X-ray photography, the humerus is transversely cut at about 3.0cm from the articular surface, and the distal segment of the anterior segment is displaced to the temporal side. It can be inserted into the proximal segment, and the distance between the lower ankle and the ankle is increased (separation). The inclination to the ulnar side is reduced, the normal is 20 ° ~ 25 °, after the fracture can be reduced to 5 ° ~ 15 ° or even disappear. On the lateral position, the distal end of the humerus is displaced to the dorsal side, and the inclination angle of the volar side of the articular surface is reduced or disappeared, and the normal angle is 10° to 15°. In the elderly, the distal segment can be a comminuted fracture.

Diagnosis and diagnosis of Coles' fracture

The patient's wrist stretched down, and the palm of the hand fell to the ground. The wrist felt severe pain, and did not dare to move. The swelling was especially swollen with local swelling. Sometimes the subcutaneous congestion was seen. The finger was in a semi-flexed rest position, and the fist was not allowed to make a fist. The hand can relieve some pain. Such as proximal fracture pressure and median nerve, there are signs of median nerve dysfunction such as finger numbness.

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