Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Colles’ fracture Colles fracture ++ 813.14 Colles’ fracture closed813.51 Colles’ fracture open ++ S52.539A Colles’ fracture of unspecified, radius, initial encounter for closed fractureS52.539B Colles’ fracture of unspecified radius, initial encounter for open fracture type I or IIS52.539C Colles’ fracture of unspecified radius, initial encounter for open fracture type IIIA, IIIB, or IIIC ++ 4G: Impaired Joint Mobility, Muscle Performance, and Range of Motion Associated With Fracture1 +++ Description ++ FractureAny defect in continuity of the distal radiusDisplaced (distal radius is moved on either side of the fracture) or non-displaced (distal radius has not moved)Closed (skin intact) or open (skin breached) +++ Essentials of Diagnosis ++ Diagnosis usually made by clinical examinationMay not be fracture, but distal radioulnar subluxation/dislocation, wrist sprain +++ General Considerations ++ Radius is the most commonly broken bone in the armMost common fracture site in children (35.8% to 45% of all pediatric fractures) +++ Demographics ++ In pediatric population, higher frequency among boys than girls +++ Signs and Symptoms ++ Pain Point tendernessEdemaEcchymosisVisual wrist deformityLoss of general functionLoss of active mobilityMuscle guarding with passive movementCrepitus +++ Functional Implications ++ Pain with weight bearing on involved forearm and handPain with vertical positioning of arm at sidePain with all movements (passive, active) +++ Possible Contributing Causes ++ OsteoporosisMechanisms of injury Fall on outstretched hand with the wrist in extensionDirect impact +++ Differential Diagnosis ++ Distal radioulnar subluxation or dislocationWrist sprain +++ Imaging ++ X-ray for fracture, often limited viewCT for detailed imagingMRIUltrasonography may be used in pediatric population ++ Pain and crepitus with passive or active ROM in wrist and forearmVisible wrist deformity Upper extremity held in protective position to avoid gravitational distraction of jointMuscle guarding with all movementsInability to actively perform wrist movements or forearm pronation/supination secondary to pain If vascular structures involved, affected hand will appear cool, pale, diminished palpable pulseIf neurologic structures involved, individual will report numbness, decreased ability to move affected hand ++ To hospital for imaging: x-ray or CTTo physician for medication: NSAIDs or opioid for pain managementTo orthopedist for immediate consult ifNon-displaced fractures or displace fractures that may be reduced are treated non-operativelyImmobilization splint, castingSeverely displaced fractures treated operatively viaOpen reduction internal fixationExternal fixation ++ Inability to Perform ADLs with involved upper extremityBear weight on involved forearm and handWrite with involved hand (especially if dominant hand affected)Grab a cup secondary to pain and muscle ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth