Differential diagnosis

It is important to exclude a Galeazzi fracture in patients with a suspected Colles' fracture as the former requires internal fixation. (1)

Colles' fracture does not occur in children. A more likely explanation of a 'dinner fork' deformity in such patients would be be a greenstick fracture of the distal radius or a fracture separation of the radial epiphysis.

Smith fracture: Often referred to as a “reverse Colles,” the Smith fracture involves volar (rather than dorsal) angulation of the distal radial fragment and is usually caused by a fall onto an outstretched hand in supination rather than in pronation.(2)

Barton fracture: A Barton fracture is a type of distal radius fracture that involves the dorsal rim of the distal radius, in which an oblique intra-articular fracture occurs. (3)

Hutchinson or Chauffer fracture: Intra-articular radial styloid fractures are also known as Hutchinson or Chauffer fractures and usually present as oblique or transverse fractures to the radial styloid caused by direct trauma. (4)

Monteggia fracture: This is an ulnar shaft fracture with associated radial head dislocation (5)

References

1. Ciminero M et al. Isolated Distal Ulna Fracture With Distal Radioulnar Joint Dislocation: A Novel Fracture Pattern. Hand (N Y). 2020 Jul;15(4):NP57-NP62
2. Schroeder JD, Varacallo M; Smith's Fracture Review. StatPearls, Jan 2022.
3. Szymanski JA, Reeves RA, Carter KR; Barton's Fracture. StatPearls, Jan 2022.
4. Andreotti M, Tonon F, Caruso G, et al; The "Chauffeur Fracture": Historical Origins of an Often-Forgotten Eponym. Hand (N Y). 2020 Mar;15(2):252-254.
5. Kliushin NM et al. Treatment of forearm diaphyseal defect by distraction compression bone transport and continued distraction for radial head reduction: A case study. Chin J Traumatol. 2019 Oct;22(5):304-307