((21-C) Articular fracture involving articular surface of two bones.(21-B3) Articular of one bone, extra-articular of other.(21-B) Articular fracture involving articular surface of only one of the two bones.The Trauma Association classification is widely accepted and under constant review. Most wrist fracture systems have failed to accomplish any of these goals and there is no consensus about the most useful one. In medicine, classifications systems are devised to describe patterns of injury which will behave in predictable ways, to distinguish between conditions which have different outcomes or which need different treatments. If the surface is very irregular, the optimal treatment is fusion. Irregularity may result in radiocarpal arthritis, pain, and stiffness. The surface is not smooth if there is more than 1 mm step deformity, and is associated with posttraumatic arthrosis.
If the radial length remains uncorrected, ulnar impaction syndrome may occur.Īny articular joint surface must be smooth for it to function properly. The radius length would be too short if there is greater than neutral variance, especially when compared to the opposite side of the body. The core question that must be answered is "is it short?" Radial length is one of the important considerations in a distal radius fracture. The upper limit of an acceptable deformity after reduction of the fracture is 5° of dorsal tilt. When dorsal tilt beyond the acceptable threshold occurs, distal radio-ulnar joint motion is altered, and forearm rotation becomes restricted. However, tilt away from the thumb (dorsal tilt) beyond this point (>11° deviation) requires reduction of the fracture. Normally, the angle is turned down toward the thumb (volar tilt) by 11°.Īs pressure is applied to the radius, the cup may become aligned differently.Īlignment up to 0° is still considered to be functional, and does not require any intervention. The lateral articular angle is the angle between the axis of the radius and the articular cup. Investigation of a potential distal radial fracture includes assessment of the lateral articular angle, radial length, and articular surface. CT scan is often performed to investigate the exact anatomy of the fracture, especially if surgery is considered. X-ray of the affected wrist is required if a fracture is suspected. Swelling and displacement can cause an acute carpal tunnel syndrome.ĭiagnosis may be evident clinically when the distal radius is deformed but should be confirmed by x-ray.ĭifferential Diagnosis includes scaphoid fracture and wrist dislocation which can also co-exist with a distal radius fracture. Injuries to the elbow, humerus and shoulder are also common after a FOOSH (fall on out-stretched hand).
#Colles fracture vs smith fracture x ray skin#
Examination should rule out a skin wound which might suggest an open fracture, loss of sensation or loss of circulation to the hand. Radial styloid and ulnar styloid may be at the same level. Broadening of the wrist can be perceived. Inability to use the hand is also common.ĭeformity, tenderness and loss of wrist motion are normal features on examination of a patient with a distal radius fracture. They frequently also notice deformity of the wrist and swelling. Patients usually present with a history of an injury and localized pain. The risk of injury is increased in patients with osteoporosis and other metabolic bone diseases. In young adults it is the result of moderate to severe force. The most common cause of this type of fracture is when an individual falls on an outstretched hand ( acronym: FOOSH). It is less common in young adults but because it requires greater force, the injury is often very severe in this age group. A similar fracture in children involving the growth plate is called a Salter Harris Fracture. Also a common injury in children where it may involve the growth plate. Common fragility fracture in the elderly. This is the most commonly occurring fracture in adults. Most of these names are applied to specific patterns of distal radius fracture but confusion exists because "Colles' Fracture" is used (for example by the US National Library of Medicine) as a generic term for distal radius fracture. Wrist fracture fractured wrist Colles' fracture Smith's fracture Barton's fracture Chauffeur's fracture (so called because the crank used to start old cars often kicked back and broke the chauffeurs' wrists with a particular pattern). Because of its close proximity to the wrist joint this injury is often called a wrist fracture.
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