Radiology Corner

Colles' Fracture of the Wrist

June 1 2002 Terry R. Yochum
Radiology Corner
Colles' Fracture of the Wrist
June 1 2002 Terry R. Yochum

I n 1814, Abraham Colics wrote the definitive description of this fracture, which conse­quently bears his name.' The injury is de­fined as a fracture of the distal radius approxi­mately 20-to-35 mm proximal to the articular sur­face, with posterior angulation of the distal frag­ment. More than 60% will have an accompanying fracture of the ulnarstyloid process.1 The usual mechanism is a fall on an outstretched, extended hand. The physical appearance of the fractured distal forearm and wrist lias led to its being called the dinner fork deformity. The incidence of the fracture increases with age, and this increase is so rapid in women that, by age sixty-five, the lesion is six times more com­mon in women than in men.2 Osteoporosis ap­pears to be the underlying influencing factor. Complications are common and may be severe.2 The radiologic features are distinctive and rela­tively consistent.2 Fracture Line. Usually transverse and comminuted, it is normally readily visible. A variable degree of impaction is apparent on the dorsal surface at the fracture site. Radial Contour. A sharp cortical overlap is seen at the fracture site, especially visible on the frontal projection, due to the proximal migration of the distal fragment. Radial Length. The overall length of the radius is decreased due to the proximal migration of the distal fragment. Angulation. The distal fragment is tilted dorsally, as evi­denced by the altered angle of the articular surface, which is seen on the lateral projection. Normally, there is a five-to fifteen degree palmar angulation of the articular surface. • Soft tissue. The distorted skin contour is apparent. The pronator quadratus fat plane will usually be altered. | Dr. Terry R. Yochum is a second-generation chiropractor and a cum laudc graduate of the National College of Chiropractic, where he subse­ quently completed his radiology specialty. He is currently Director of the Rocky Mountain Chiropractic Radiological Center, in Denver. CO. an Adjunct Professor of Radiology at the Los Angeles College of Chiroprac­ tic, as well as instructor. Skeletal Radiology, University of Colorado School of Medicine. Denver. CO. Dr. Yochum is. also, a consultant to Health Care Manufacturing Company that offers a Stored Energy system. For more information. Dr. Yochum can he reached at: (303) 940-9400 or by e-mail at drradO99(8)anl. com. %