| ID | 246 |
|---|---|
| Name | COLLE’S FRACTURE (Fracture of the Lower end of Radius) |
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| Introduction | Colle’s fracture is defined as fracture of the lower end of radius 2 cm. proximal to the distal articular surface with or without avulsion of ulner styloid prosess, with dislocation of distal radio-ulner joint. It is produced by a fall on to the palm of the outstretched hand. Occurs usually after the age of 40. It is particularly common in women. The typical deformity: The typical displacement is reflected in a charac-teristic clinical appearance that has been termed the dinner fork deformity. There is a dorsal hollow of depression in the lowest third of the forearm. Immediately below this, there is a marked prominence ( caused by the lower fragments being displaced back wards) Displacement of distal part: 1. Dorsal displacement. 2. Dorsal angulation. 3. Proximally drawn. 4. Lateral angulation. 5. Supination. |
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| Clinical Features | Treatment: In displaced fractures, the standard method of treatment is- 1. To undertake manipulative reduction under anesth-esia, i.e reduction- a. Give general anesthesia (to relax the forearm muscles), b. Disimpaction of the fragments- by longitu-dinal traction upon the hand and thumb against the counter traction of an assistant who grips the arm above the fixed elbow, c. Reposition of the distal fragments. - Palmer flexion & ulnar deviation, thus lateral angulation is corrected. - Pronation thus supinarion is corrected. 2. To immobilize the forearm and wrist in a below-elbow plaster i.e. immobilization - After reduction, a plaster is applied with the wrist in the neutral position. Two types of plaster as in common use- i. The complete encircling plaster & ii. The dorsal plaster slab. While the limb is in plaster, the patient should be encouraged to use the hand freely for every day activities and deliberate exercises should be carried out for the fingers, elbow and shoulder. The plaster should be retained usually for 6 weeks. Check circulation is alright. |
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