Uncommon in Colle's fracture: March 2007
Ans. A: Non-union A. CoIle's fracture is usually produced by a FOOSH (fall on an outstretched handy mechanism with the wrist in dorsiflexion. The fracture is dorsally displaced and may be comminuted. The fracture pattern is often described as a silver or dinner-fork deformity. Two classification systems are used: The Association for Osteosynthesis (AO) system The Frykman system. Complications of the Colles fracture include: Post-traumatic stiffness Mal-union Subluxation of the inferior radio-ulnar joint Acute carpal tunnel syndrome Sudeck's osteodystrophy. Rupture of the extensor pollicis longus tendon B. An impact to the dorsum of the hand or a hyperflexion or hypersupination injury results in Smith's fracture. A Smith fracture is usually called a reverse Colles fracture because the distal fragment is displaced volarly. It is often described as a garden-spade deformity. C. Baon fractures are classified as dorsal or palmar (always intra-aicular), and they always involve carpal subluxation. The volar Baon fracture is thought to occur with the same mechanism as the Smith fracture, with more force and loading on the wrist. The dorsal Baon fracture is caused by a fall on an extended and pronated wrist, increasing carpal compression force on the dorsal rim. The salient feature is a subluxation of the wrist. By definition, this fracture has some degree of carpal displacement, which distinguishes it from a Colles or Smith fracture. The palmar variety is more common than the dorsal type. D. The chauffeur's fracture derives its name from injuries that were acquired, in the days when motor vehicles were cranked, when a vehicle backfired. The force is described as a direct axial compression of the scaphoid into the radial facet. The radial styloid is fractured, with associated avulsion of the radial collateral ligament. A chauffeur's fracture represents an avulsion related to the attachment sites of the radiocarpal ligaments or of the radial collateral ligament. E. Galeazzi fracture results from a FOOSH mechanism with the forearm hyperpronated or from a direct impact to the dorsal radial wrist. The radial diaphysis at the distal and middle third junction is fractured, with associated subluxation of the distal radioulnar joint. On PA views, the radius is shoened and the radioulnar joint is disrupted. On the lateral view, the distal radius is angulated either volarly or radially as a result of the pull of the brachioradialis muscle with more than 3 mm of ulnar displacement. F. The Essex-Lopresti fracture consists of a comminuted and displaced radial head fracture along with disruption of the distal radioulnar joint and interosseous membrane.
Non-union
Mal-union
Rupture of EPL tendon
Reflex sympathetic dystrophy