Clinical features
Classically, the fracture presents with a 'dinner fork' deformity of the wrist. (1,2)
There are five components to the deformity:
- dorsal angulation of the distal fragment
- dorsal displacement of the distal fragment
- radial deviation of the hand
- supination
- proximal impaction
Radiology reveals a transverse fracture of the distal radius about 2.5 cm from the wrist. The fragment is tilted and shifted backwards and radially, with proximal impaction. Occasionally, the distal fragment is severely comminuted or crushed. Frequently, there is an associated fracture of the ulnar styloid.
In severe cases, there may be dislocation of the distal radio-ulnar joint or fracture of the styloid process of the ulna.
Reference
- Black WS, Becker JA; Common forearm fractures in adults. Am Fam Physician. 2009 Nov 15;80(10):1096-102.
- Sharp JW, Edwards RM. Core curriculum illustration: "Colles," dorsally angulated fracture of the distal radius. Emerg Radiol. 2019 Dec;26(6):699-700.
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