Commonest fracture in elderly with fall on outstretched hand is ?
Correct Answer: Colle's fracture
Description: Ans. is 'a' i.e., Colle's fracture Colle's fracture is the most common fracture in person over 40 years. Colle's fracture Colle's fracture is an extra-aicular fracture at the distal end of radius, at its coico-cancellous junction. It is the most common fracture in person over 40 years of age and especially in women after menopause (Postmenopausal females). The association of the fracture with osteoporosis is now well established and it is one of the fragility fracture, seen in osteoporosis. The fracture nearly always caused by fall on outstretched hand. Displacement in colle's fracture The fracture line runs transversely at the coico-cancellous junction. In the majority of the cases, one or more displacements of the distal fragment occur :- Dorsal displacement (Dorsal shift) i Dorsal tilt (Dorsal angulation) Lateral displacement (lateral shift) Clinical features of colles fracture Lateral tilt (lateral angulation) Supination (external rotation) Impaction (proximal migration) Pain and swelling at the wrist. Typical deformity : There is a dorsal hollow or depression just proximal to the fracture and immediately distal to this there is a marked prominence caused by lower fragment being displaced backwards, carrying with it the whole of the carpus and hand. This gives appearance of a fork, So named dinner fork/ silver fork /spoon shaped deformity. There is local tenderness. Treatment of colle's fracture Treatment of colle's fracture is essentially conservative. For undisplaced fracture below-elbow cast is given in-situ. For displaced fractures, the standard method of treatment is to undeake manipulative reduction under local or general anaesthesia. Technique of closed manipulation involves reversing the typical deformities of colle's fracture (in following sequence) :- Disimpaction (by traction) :- to correct impaction. Palmer flexion & ulnar detion :- to correct dorsal tilt / shift and radial tilt / shift. Pronation (internal rotation) :- to correct supination (external rotation). After reduction below elbow cast is given.
Category:
Surgery
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