Which of the following displacement is not seen in Colic's fracture?
Ans. b. Volar tilt (Ref: Apley 9/e p773; Rockwood 6/e p910-943: Campbell's 10/e p3058-3068: Maheshwari 3/e p 95-96)Volar tilt is not seen in Colic's fracture.Displacements of Colle's Fracture:It results in dinner fork / silver fork / spoon shaped deformity (With six displacements; Mnemonic-'DILS')* Dorsal displacementQ* Dorsal tiit/angulationQ* ImpactionQ (Proximal shift)* Lateral displacementQ* Lateral tilt angulationQ* SupinationQ Colle's FractureColle's fracture is fracture of lower end of radius at its cortico cancellous junctionQMostly occurring in post menopausal osteoporotic elderly womenQAs a result of fall on outstretched hand with wrist in extension.It is MC of all fractures In older peopleQ.Mechanism of Injury:Falling on to the outstretched hand with wrist in extension, the thener eminence takes the brunt of force. This results in fracture of lower end of radius, rotating it in to supination with the centre of rotation at the ulnar styloid.If the force continues the ulnar styloid is avulsed and triangular fibrocartilage complex is injured.Displacements of Colle's Fracture:It results in dinner fork/silver fork/spoon shaped deformity (With six displacements: Mnemonic-'DILS')* Dorsal displacementQ* Dorsal tilt/angulationQ* ImpactionQ (Proximal shift)* Lateral displacementQ * Lateral tilt angulationQ * SupinationQPosition of immobilization in Colle's fracturePalmar deviationQ (Flexion)PronationQUlnar deviationQComplication of Colle's Fracture* Joint Stiffness- Finger stiffness is NIC complicationQ.- Wrist, elbow, and shoulderQ are other joints to become stiff.* Malunion is the 2nd MC complicationQ and it leads to dinner fork deformityQ* Sudeck's osteodystrophy / Reflex sympathetic dystrophy:- It is quite common but seldom progress to hill-blown picture of sudeck's atrophy.- Colle's fracture is the commonest cause of sudeck's dystrophy in upper limbQ.* Shoulder Hand Syndrome:- Characterized by a swollen, painful, stiff hand and a 'frozen shoulder'.* Rupture of extensor pollicis longus tendonQ* Carpal tunnel syndrome causing median nerve compressionQ.* Carpal instabilityQ* Triangular- fibrocartilage complex injuryQ and subluxation of inferior radioulnar joint.* Delayed union and nonunion are extremely rare.
Radial tilt
Volar tilt
Dorsal displacement
Supination
Injuries of the Forearm