Malunited Colles This ppt is good for ur studies you can achieve good score

Malunited colles

1. MALUNITED COLLES

2. DEFINITION A M alunited Colles ' fracture refers to the improper healing of a distal radius fracture, resulting in deformity and functional impairment. It is an extraarticular fracture that occurs at corticocancellous junction of distal end of radius within 2 cm from the articular surface. Most common age group is above forty years, occuring most commonly in women.

3. Mechanism of Injury Typically occurs due to a fall on an outstretched hand, with the wrist in dorsiflexion (extended backward), causing a dorsal displacement of the distal radius.

4. PATHO-ANATOMY Displacement: The fracture line runs transversely at the cortico -cancellous junction. In many cases one or more displacements may occur as follows. Impaction of fragments Dorsal displacement Dorsal tilt Lateral displacement Lateral tilt Supination

5. CLINICAL FEATURES Pain Swelling Deformity- There is classic 'dinner-fork deformity' seen in colles ' fracture. Radial styloid process lies in the same level or little higher than the ulnar styloid process.

6. DIAGNOSIS Radiological Features-
It is important to differentiate colle’s fracture than other fractures occurring at the same site, such as Smith’s fracture, Barton’s fracture looking at the displacements.

7. X-RAY: Lateral view • Dorsal tilt- It can be detected by looking at the direction of distal articular surface . AP view Lateral tilt- similarly it can be detected by looking at the articular surface if it faces medially it is normal, if it becomes horizontal or faces laterally, a lateral tilt is present.

8. TREATMENT Conservative Method For Undisplaced fracture- immobilisation in a below-elbow plaster for six weeks For Displaced fractures- Manipulative reduction followed by immobilization in a colles cast.

9. Manipulative Reduction

10. Surgical method Closed reduction and percutaneous pinning with k – wires Open reduction and plate fixation.

11. COMPLICATIONS Stiffness of joints Mal-union Subluxation of the inferior radio-ulnar joint Carpel-tunnel syndrome Sudeck's osteodystrophy Rupture of the extensor pollicis longus tendon

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