Three years after Colles' fracture. A prospective review

Abstract

When Colles first described his familiar fracture in 1814, he claimed that the injured limb would eventually regain â€oeperfect freedom in all its motions―. Though some would agree with such an observation (Smaill 1965), many would not (Grasby and Trick 1929;Mayer 1940; Bacorn and Kurtzke 1953; Golden 1963;Cole and Obletz 1966). Frequent attempts have therefore been made to identify, as early as possible, the factors which may lead to a poor result.A number of radiographic features have been regarded as important for prognosis, notably intra articular involvement (Eelma and McElfresh 1983), volar tilt (Rubinovich and Rennie 1983), dorsal tilt,

Plaster cast compared with bridging external fixation for distal radius fractures of the Colles' type

“…Remarkably, we did not find any statistically significant difference between the two groups regarding the radial length. This is in contradiction to other investigators who had found the shorting of the radial length to be the most important factor in favor of external fixation [7,21,26].…”

The radioulnar joint in distal radial fractures: A review

“…There are no radiological markers in patients with peripheral TFCC-tears (Lindau et al 1997(Lindau et al , 2000a or laxity of the DRU-joint (Lindau et al 2000a, b). This is consistent with previous studies where outcome showed no correlation with fracture classi cation (Flinkkilä et al 1998) or fracture of the ulnar styloid (Villar et al 1987, Aro and Koivonen 1991, Warwick et al 1993, Poirier 1994.…”

“…Malunion, with axial shortening of the distal radius, is generally associated with a worse outcome (Lidström 1959, Frykman 1967, Hollingsworth and Morris 1976, van der Linden and Ericson 1981, Villar et al 1987, Kopylov et al 1993, Warwick et al 1993, Hove et al 1995, Stoffelen 1997. However, a few authors have reported patients with malunion who are asymptomatic; they concluded that the anatomical end-result does not matter (Dias et al 1987.…”

“…However, the usefulness of Frykman's classi cation has been questioned (Andersen et al 1996), since others have reported no correlation between this classi cation and outcome (Flinkkilä et al 1998). Furthermore, several studies have found no correlation between ulnar styloid fractures and the end-result (Villar et al 1987, af Ekenstam et al 1989, Aro and Koivonen 1991, Warwick et al 1993, Poirier 1994, Lindau et al 2000a). This may be because in previously described reports, acute TFCC-tears can occur without ulnar styloid fractures (Geissler et al 1996a, Lindau et al 1997, Richards et al 1997).…”

“…The commonest complaint after distal radial fractures is ulnar-sided wrist pain (Frykman 1967, Cooney et al 1980, Altissimi et al 1986, Solgaard 1988, found in every fth patient (Frykman 1967), which affects the end-result adversely (Frykman 1967, Hollingsworth and Morris 1976, Jupiter et al 1992, Stoffelen et al 1998. Such pain has been attributed mainly to malunion of the distal radius (Lidström 1959, Frykman 1967, Hollingsworth and Morris 1976, van der Linden and Ericson 1981, Villar et al 1987, Kopylov et al 1993, Warwick et al 1993, Hove et al 1995, Stoffelen 1997) thus creating an imbalance distally, which may lead to both ulnocarpal abutment (Bowers 1999), as well as incongruency (Kihara et al 1995) and osteoarthrosis of the distal radioulnar (DRU) joint (Fernandez 1993). It has recently been suggested that in many cases common distal radial fractures are complicated by ligament injuries, found on wrist arthroscopy (Geissler et al 1996a, Lindau et al 1997, Richards et al 1997).…”