A Barton’s fracture is an intra-articular fracture of the distal radius with dislocation of the Intra-articular component distinguishes this fracture from a Smith’s or a Colles’ fracture. Treatment of this fracture is usually done by open reduction and. 12 abr. dificuldades em realizar pronação e. supinação do antebraço e limitação das. falanges. – Presença de sinais flogísticos: Abraham Colles. Fractures of the distal radius (Colles’ fracture). Fraturas do rádio distal (Fratura de Colles). João Carlos Belloti; João Baptista Gomes dos.
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They consist of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without the involvement of the articular surface. This article describes radiographic features to check for and possible complications. They are particularly common in patients with osteoporosisand as such, they are most frequently seen in elderly women.
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The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated 1. Younger patients who sustain Colles fractures have usually been involved in high colels trauma or have fallen, e.
Most Colles fractures are secondary to a fall on an outstretched hand FOOSH with a pronated forearm in dorsiflexion the position one adopts when trying to break a forward fall.
The proximal row of the carpus particularly the lunate and scaphoid transfer energy to the distal radius, both in the dorsal direction and along the long axis of the radius. Most fractures are therefore dorsally angulated and impacted. A number of classification systems exist for distal forearm fractures. One of the more popular is the Frykman classification systemalthough it fails to distinguish between Smith and Colles fractures as it is based on AP radiographs As such, in clinical practice, the use of the term Colles fracture with an appropriate description of any associated injuries is sufficient in most instances.
Plain films usually suffice, although if there is a concern of intra-articular extension, then CT may be beneficial. The plain radiographic series often comprises an AP and a lateral view; however, it is not uncommon for an oblique view to be included.
The fracture appears extra-articular and usually proximal to the radioulnar joint. Dorsal angulation of the distal fracture fragment is present to a variable degree as opposed to volar angulation of a Smith fracture.
There is also usually impaction with resultant shortening of the radius.
In addition to noting the presence of a fracture a number of features should be sought and commented upon:.
The vast majority of Colles fractures can be treated with closed reduction and cast immobilisation. The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation 4 – for those of you familiar with Australian rules football; this position is reminiscent of the position adopted when holding a ball in preparation for a kick.
This cast is known as a Colles cast 4.
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About Blog Go ad-free. Teaching Atlas of Musculoskeletal Imaging. Read it at Google Books – Find it at Amazon. Edit article Share article View revision history. Synonyms or Alternate Spellings: Colles’ fracture Colles fractures.
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