Distal Radius Fracture

Normal radiographic anatomy of the wrist:
Radial inclination : 23 (13 - 30 )
Radial positive : 13mm (8 - 18mm)
Volar tilt : 11 (1 - 21 )
COLLES' FRACTURES
Frykman Classification
Type I, II : Extraarticular fracture
Type III, IV : Involve radiocarpal joint
Type V, VI : Involve distal radioulnar joint
Type VII, VIII : Involve both radiocarpal and distal radioulnar joints
Type I, III, V, VII : Intact ulnar styloid
Type II, IV, VI, VII : Fractured ulnar styloid
Mechanism of Injury
Fall on outstretched hand
Examination
Tender and swollen wrist with dinner-fork deformity
Management
Extra-articular fractures:
Attempt M&R under Bier's block
Apply traction with forearm pronated, wrist slightly flexed and ulnar deviated
> 65 years old or poor functional status : Short arm backslab
< 65 years old or good functional status : Long arm backslab Check X-rays to assess adequacy of reduction: 1. volar tilt or at least neutral position on lateral X-ray 2. Radial positive 3. Radial inclination at least 10 4. < 1mm intraarticular gap ( for intraarticular fractures ) If reduction satisfactory : TCU Ortho 1/52 with X-rays OA If reduction unsatisfactory : Consider repeat M&R. Admit to Ortho Dept if reduction still poor Intraarticular Fractures >65 years old or poor functional status : Manage as for extraarticular fractures
<65 years old or good functional status : Admit to Ortho Dept for surgery