The Pathology, Etiology, Epidemiology, Clinical manifestations, Prognosis, Diagnosis, and Complications of Colles Wrist Fracture – The wrist is an important part that connects the forearm by hand and forms the base of the hand. Any injuries that occur to it will decrease and can even negate the basic functioning of the hand.
The Colles fracture is the most common wrist fracture, with an incidence of 24% among the worker population, where the radius of the fracture causes the parts to be shifted radial and dorsal.
Colles fracture is also the most common fracture in older people over 50 years old and is more common in women than men. This is due to the start of post-menopausal osteoporosis where falling with outstretched hands is the most common cause.
Pathology of Colles fracture
Trauma that causes fractures in the wrist area is usually a direct trauma, which is to fall on the volar or dorsal side of the hand.
Falling on the surface of the hand side to the volar causes the dislocation of the fractures of the distal to the dorsal.
This dislocation causes the shape of the forearm and the hand when viewed from the side resembling a fork.
The types of colles wrist fracture include:
- Type 1: Extra articular fracture radius
- Type 2: Extra-articular radius fracture with ulna fracture
- Type 3: Intra-articular radius fracture involving the radiocarpal joint
- Type 4: Intra-articular radius fracture involving the radiocarpal joint accompanied by ulna fracture
- Type 5: Intra-articular radius fracture involving the distal radioulnar joint
- Type 6: Intra-articular radius fracture involving the distal radioulnar joint accompanied by a distal ulnar fracture
- Type 7: Intra-articular radius fracture involving the radiocarpal joint and distal radioulnar.
- Type 8: fractures of the distal radiocarpal and radioulnar joints with ulnar fragment.
Trauma due to a hand position that hyperextensions when falling
Often in children and elderly. Because the bones of children are still soft and bones become more porous in the elderly so easy fracture occurs.
- Pain in the wrist (the presence of muscle spasm, pressure from bone fracture or surrounding tissue damage.)
- Swelling of the wrist (due to localized serous fluid in the fractures area and extravasation of the surrounding tissues)
- Bruising / ecchymosis
- There is a deformity over the wrist (dinner fork deformity)
- Cannot hold objects that are not heavy.
Dubia ad bonam
Distal Radius Fracture Diagnosis
The Diagnosis of the distal radius fracture consists of other fractures or only injuries. To that end, it is necessary to have an adequate physical examination, especially a special picture of the distal radius fracture, followed by a supporting examination to determine the correct diagnosis.
The thing to ask when anamnesis in the case of distal radius fracture is as follows:
- Identity (gender, age)
- Trauma mechanisms
- Onset of Occurrence
- Symptoms of wrist pain, swelling, limited range of motion, deformities
As with most fractures, an open wound, edema, deformity, limitation of the range of movement, wrist pain is moved or local press pain. Anatomical snuffbox Press pain can indicate a scaphoid injury.
Some fractures provide a distinctive picture as follows:
Looks “Dinner fork deformity”. This deformity is characterized by protrusion to the back of the wrist.
These fractures are characterized by distal fragment shifting and protruding towards the anterior. It appears to be the opposite of the Colles fracture. Garden-spade deformity.
Colles Wrist Fracture Complications
When soft tissue is damaged, there will be risks accompanying when the condition is not treated immediately. The problem of the emergence of other health complaints can be:
- The ulnar and median nerves around the site are traumatized and become more sensitive (painful and sore) against friction and touch. This condition is very agonizing if people with colles fractures have rheumatic diseases or symptoms of osteoporosis.
- Tendons suffer from damage so as to affect the surrounding tissues, including the condition of susceptible bones subjected to colles fractures. Tendons function is very related to the bones because the presence of tendons is a subtle organ that supports the movement of the bones so that one can do activities with infinite movement.
- There are problems of arthrosis and prolonged pain in the areas of the bones affected by the colles wrist fracture, causing a person to develop insomnia due to pain that always arise at night.
- The shape and structure of the bones subjected to colles fractures can undergo changes and restrict bone movement when moved. The sufferer will feel the pain with imperfect bone shape or a symmetrical (there is a protrusion or shorter size).
- Experiencing muscular fatigue when bones are used for heavy activity or activities that rely on hand strength, such as lifting loads that are repeated every day.
- The emergence of redislocation cases, that is, when the body is hit with a hard object when falling, then the joints are injured and get a friction until it is out of the normal position in the joints so the bones to become susceptible to cracks, Brittleness and easy to break.
- Post-repositioning edema occurs after a collision occurs in the bones, especially in the wrist area. Post-repositioning Edema is the buildup of fluid inside the body tissues so appears swelling that has a pain effect.
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