Commonest fracture in elderly with fall on outstretched hand is –
Correct Answer: Colles' fracture
Description: Ans. is 'a' i.e., Colle's fracture o Colie's fracture is the most common fracture in person over 40 years. Colle's fracture o Colle's fracture is an extra-articular fracture at the distal end of radius, at its cortico-cancellous junction. It is the most common fracture in a 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 o The fracture line runs transversely at the cortico-cancellous junction, o In the majority of the cases, one or more displacements of the distal fragment occur:- i) Dorsal displacement (Dorsal shift) iv) Lateral tilt (lateral angulation) ii) Dorsal tilt (Dorsal angulation) v) Supination (external rotation) iii) Lateral displacement (lateral shift) vi) Impaction (proximal migration) Clinical features of codes fracture o Pain and swelling at the wrist. o 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 backward, carrying with it the whole of the carpus and hand. This gives the appearance of a fork, So named dinner fork/ silver fork/spoon-shaped deformity. o There is local tenderness. Treatment of Colle's fracture o manipulation involves reversing the typical deformities of Colle's fracture (in the following sequence) Disimpaction (by traction) to correct impaction. Palmer flexion & ulnar deviation to correct dorsal tilt / shift and radial tilt / shift. Pronation (internal rotation) :- to correct supination (external rotation), o After reduction below elbow cast is given.
Category:
Orthopaedics
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