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The unstable Colles' fracture.

N H Jenkins1

  • 1Department of Orthopaedic and Traumatic Surgery, University of Wales College of Medicine, Cardiff.

Journal of Hand Surgery (Edinburgh, Scotland)
|May 1, 1989
PubMed
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Colles' fractures often experience instability after initial splinting, leading to significant malunion. However, fractures without dorsal comminution showed better stability against dorsal angulation malunion.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Traumatology

Background:

  • Colles' fractures are common wrist injuries.
  • Displaced fractures require careful management to prevent malunion.

Purpose of the Study:

  • To assess radiographic changes and instability in displaced Colles' fractures after initial splinting.
  • To identify factors influencing chronic collapse and malunion.

Main Methods:

  • Radiographic assessment of 121 displaced Colles' fractures until union.
  • Analysis of positional changes, dorsal angulation, radial angle, and radial shortening.
  • Correlation of malunion with initial deformity, intra-articular involvement, and comminution.

Main Results:

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  • Acute loss of position required re-manipulation in 6 fractures.
  • Chronic instability led to mean increases in dorsal angulation (8.22°), loss of radial angle (5.61°), and radial shortening (3.26 mm) in 115 fractures.
  • Initial deformity, not intra-articular involvement or comminution, predicted chronic collapse. Absence of dorsal comminution predicted stability against dorsal angulation malunion.

    • Conclusions:

    • Colles' fractures exhibit significant chronic instability and malunion even after initial reduction.
    • Initial deformity is the primary predictor of chronic collapse.
    • Absence of dorsal comminution is a favorable prognostic indicator for stability against dorsal angulation malunion.