colles fracture课件.ppt

* Colles fracture dongzhibing See also distal radius fracture a?fracture?of the?distal?radius?in the forearm with dorsal (posterior) displacement of the wrist and hand The typical clinical symptoms dinner fork deformity bayonet deformity Terminology Transverse?fracture of the radius 2.5?cm (0.98?inches)?proximal?to the?radio-carpal joint dorsal?displacement?and dorsal angulation X-ray Causes people falling onto a hard surface and breaking their fall with outstretched arms Overuse Originally it was described in elderly and/or post-menopausal women. a common fracture in people with?osteoporosis Diagnosis Dorsal tilt Radial shortening Loss of ulnar inclination Radial angulation of the wrist Dorsal displacement of the distal fragment Comminution at the fracture site Associated fracture of the ulnar styloid process in more than 60% of cases. Complication Wrist nerves injure Carpal tunnel oppression: Median nerve Ulnar nerve Extensor pollicis longus tendon damage Four weeks after fracture or more later Sudecks osteanabrosis Pain .Swelling .Stiff in hand and wrist. Decalcification. Shoulder-hand syndrome Stiff in shoulder Malunion Fixed failure Local osteoporosis Treatment Depends on the severity of the fracture Undisplaced fracture Cast Mild angulation and displacement closed?reduction AND immobilization Significant angulation and deformity open reduction and internal fixation?or?external fixation Volar forearm splint Treatment modalities differ in the elderly ?Several established instability criteria dorsal tilt 20° comminuted fracture abruption of the ulnar styloid process intraarticular displacement 1mm loss of radial height 2mm Physiotherapy Non-Operative/ Conservative Rehabilitation Post-Op Rehab for External Fixation Post-Op Rehab for Open Reduction Internal Fixation Non-operative/Conservative Rehabilitation Acute Stage (0-8 weeks) Goals1. Protection with short-arm cast2. Control pain