Presentation
[…] the patient presents with a deformity in the wrist. [boneandspine.com]
An associated ulnar styloid fracture is present in up to 50% of cases. [radiopaedia.org]
Present Present Absent V Intra-articular Absent Absent Present VI Intra-articular Present Absent Present VII Intra-articular Absent Present Present VIII Intra-articular Present Present Present The AO and Frykman classifications are useful in discussing [emedicine.com]
Characteristics/Clinical Presentation The clinical presentation of Colles fracture is commonly described as a dinner fork deformity. [physio-pedia.com]
Entire Body System
- Pain
At follow-up, 40 patients had persistent ulnar wrist pain. The most important factor for predicting ulnar pain was final dorsal angulation of the radius. [ncbi.nlm.nih.gov]
"Dinner Fork" Deformity[11] History of fall on an outstretched hand Dorsal wrist pain Swelling of the wrist Increased angulation of the distal radius Inability to grasp object[12] Signs and Symptoms- Pain, numbness, tenderness, bruising, deformity of [physio-pedia.com]
Two weeks later he presents with significantly increased pain and deformity. He denies any new trauma, and has followed all post-operative activity restrictions. [orthobullets.com]
If pain management is started after surgery, it is too late. [31] Many modalities are available for management of pain related to surgery. [emedicine.medscape.com]
- Falling
Mechanism of Colles Fracture Colles fracture occurs when a person falls on outstretched hand with the forearm in pronation and wrist in dorsiflexion [The position one attempts to break forward fall. [boneandspine.com]
The natural response to a fall is to stretch out a hand to break the fall, and falls tend to occur more often in beginners. [physioroom.com]
Review Topic QID: 669 3 Extensor Indicis Proprius ML 3 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (OBQ06.136) A 25-year-old female falls from her horse and injures her left wrist. [orthobullets.com]
- Disability
Abstract The aims of the study were to 1) investigate the test-retest reliability, the internal consistency in instruments that measure behavioural factors and disability as well as to investigate convergent validity between the Disabilities of the Arm [ncbi.nlm.nih.gov]
It is a major cause of disability with only one in five affected patients able to fully resume prior activities. The earlier a diagnosis is made and treatment is commenced the better the prognosis. Aetiology: The aetiology is uncertain. [slideshare.net]
- Fatigue
Tell your doctor immediately if you have any of the following symptoms: chest pain leg or feet swelling fainting excessive coughing wheezing excessive fatigue The lungs depend on the heart to transport blood from the body to the lungs. [healthline.com]
- Inflammation
You will also notice sharp pain when moving the wrist, and there may be inflammation and swelling present. The most painful movements of the wrist are flexion and extension (i.e. bending or extending your wrist). [rehabmypatient.com]
[…] is reduce using the ice pack.(3) put ice pack to injured area pain and the inflammation is reduce using the ice pack.(3) splinting splinting help as a immediate management as protection by take the weight off the joint(3) splinting splinting help as [medicaljoyworks.com]
Plates and screws generally are left in place after healing, unless there is inflammation requiring their removal. [professionalortho.com]
There may be bruising on the hand due to the trauma or injury and inflammation. Read more on Ankle Injuries – First Aid, Treatment, Pain, Fracture Diagnoses : Your doctor will examine the wrist and take X-ray of the affected wrist. [diseasespictures.com]
[…] the pieces back into place With surgery—pins, wires, plates, screws, or stitches in the bone or tendons may be needed to reconnect the pieces and hold them in place Medication Prescription or over-the-counter medications may be given to help reduce inflammation [health.cvs.com]
Skin
- Purpura
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]
Musculoskeletal
- Fracture
There were no poor results in either group. 85% of type II fractures and 85% of type IV fractures treated in supination had excellent or good results. [ncbi.nlm.nih.gov]
By Colles fracture is a distal radius fracture that occurs following a fall on outstretched hand. [boneandspine.com]
Colles fracture is a common fracture in people with osteoporosis, second only to vertebral fractures. Diagnosis[edit] Colles fracture of the left hand, with posterior displacement clearly visible. [en.wikipedia.org]
[…] in women >50 distal radius fractures are a predictor of subsequent fractures DEXA scan is recommended in woman with a distal radius fracture Classification Eponyms Die-punch fxs A depressed fracture of the lunate fossa of the articular surface of the [orthobullets.com]
- Osteoporosis
Osteoporosis can be primary or secondary. Primary osteoporosis is the most common form, and is associated with aging (senile osteoporosis) and the postmenopausal state in women due to the decrease in estrogen levels following menopause. [kenhub.com]
The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated 1. [radiopaedia.org]
Skills Assess radiographs and describe the pattern of injury Recognize fractures associated with osteoporosis and initiate a workup for it. Be able to counsel a patient on lifestyle modifications that prevent osteoporosis. [orthopaedicsone.com]
Asymptomatic post-menopausal osteoporosis is common but some-times associated with pain and deformity. Symptomatic osteoporosis is usually associated with fracture. [ncbi.nlm.nih.gov]
Neurologic
- Headache
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]
Curr Pain Headache Rep. 2003 Oct;7(5):362–8. [PubMed] [Google Scholar] 58. de Girolamo G. Epidemiology and social costs of low back pain and fibromyalgia. Clin J Pain. 1991;7 Suppl 1:S1–7. [PubMed] [Google Scholar] 59. [ncbi.nlm.nih.gov]
- Seizure
Theophylline has a narrow therapeutic index, and adverse effects include seizures, tachycardia, and other cardiac arrhythmias. Warfarin Anticoagulation with warfarin is recommended in patients at high risk for thromboembolism. [emedicine.medscape.com]
Causes of syncope are manifold, but may include cardiac arrhythmias (irregular heart beat), vasovagal syncope, orthostatic hypotension (abnormal drop in blood pressure on standing up), and seizures. [en.wikipedia.org]
- Encephalopathy
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]
비마비성 회백수염(Acute nonparalytic poliomyelitis) A80.9 상세불명의 급성 회백수염(acute poliomyelitis, unspecified) A81 중추 신경계의 슬로우 바이러스 감염(Slow virus infections of central nervous system) - A81.0 크로이츠펠트-야콥병(Creutzfeldt-Jakob disease) 아급성 해면양 뇌병증(Subacute spongiform encephalopathy [dic.impact.pe.kr]
Workup
Skills Assess radiographs and describe the pattern of injury Recognize fractures associated with osteoporosis and initiate a workup for it. Be able to counsel a patient on lifestyle modifications that prevent osteoporosis. [orthopaedicsone.com]
[…] with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated. [10] An increasing awareness of osteoporosis has led to these injuries being termed fragility fractures, with the implication that a workup [physio-pedia.com]
An increasing awareness of osteoporosis has led to these injuries being termed fragility fractures, the implication being that a workup for osteoporosis should be a standard part of treatment. [emedicine.medscape.com]
Treatment
[…] surgical treatment to patients who cannot or do not want to accept the constraints of cast treatment because of ADL, work, or recreational concerns. [emedicine.medscape.com]
A higher amount of instability criteria increases the likelihood of operative treatment. [en.wikipedia.org]
[…] a. ( ) Yes, in about 5% of surgical treatments b. ( ) I never use them c. ( ) Yes, in about 20% to 40% of surgical treatment d. ( ) Yes, in more than 50% of surgical treatments e. ( ) Yes, in all surgical treatments 8) Which is the most frequent complication [scielo.br]
CONCLUSIONS: Brazilian orthopedists have concordant opinions regarding conservative treatment methods and the use of bone grafts. There were conflicting opinions regarding surgical treatment methods, classification types and complications. [ncbi.nlm.nih.gov]
Prognosis
Four Fractures of the Wrist Rolando, Bennett, Barton, Colles Four Fractures of the Wrist Rolando Fracture Bennett Fracture Comminuted Intra-articular Fracture through base of thumb Prognosis: worse than Bennett's fracture (difficult to reduce) Intra-articular [learningradiology.com]
Colles' fracture Specialty Emergency medicine, orthopedics Symptoms Pain, swelling, deformity, bruising[2] Usual onset Sudden[2] Causes Fall on an outstretched hand[2] Risk factors Osteoporosis[2] Diagnostic method X-rays[2] Treatment Cast, surgery[3] Prognosis [en.wikipedia.org]
CONCLUSIONS: Bone loss during the course of treatment will have a direct effect upon the prognosis, so different treatment should be proposed for different patterns of fractures. Active exercise should be made to improve the recovery of bone mass. [ncbi.nlm.nih.gov]
[…] dorsal angulation the degree of impaction degree and direction of displacement location of the medial fracture line: does it involve the radioulnar joint presence of intra-articular fractures other fractures ulnar styloid carpal bones Treatment and prognosis [radiopaedia.org]
Etiology
Compartment syndromes may be important as etiologic and complicating factors. Hyperbaric oxygen may have therapeutic value but its use has not improved on survival rates achieved during World War II with surgery and antibiotics alone. [ncbi.nlm.nih.gov]
Etiology bilateral neuromuscular disorders, e.g. cerebral palsy often have concurrent femoral anteversion skeletal dysplasias, e.g. [radiopaedia.org]
Lung Biopsy Lung biopsy may occasionally be indicated to determine the etiology of underlying lung disease. This is especially true if interstitial lung disease (ILD) is the suspected etiology for pulmonary hypertension resulting in cor pulmonale. [emedicine.medscape.com]
Epidemiology
Bhimani For patient information, click here Distal radius fracture Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Distal radius fracture from other Diseases Epidemiology and [wikidoc.org]
Fracture of the distal radius: epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol. 2014 Sep;203(3):551-9. [PubMed: 25148157] 4. MacIntyre NJ, Dewan N. [ncbi.nlm.nih.gov]
Epidemiology. Colles' fracture. Questionnaires. Prospective studies. [scielo.br]
[…] displacement, the number of bone fragments, whether or not the break is "intra-articular" (involves the wrist joint), as well as the person's age, gender, and medical history, and may range from two months to a year or more for complete recovery.[2] Epidemiology [en.wikipedia.org]
Pathophysiology
Pathophysiology Distal radius fractures are most commonly caused by a fall on an outstretched hand (FOOSH). Due to osteoporosis, the risk of these fractures increases with age (termed ‘fragility fractures’). [teachmesurgery.com]
Bhimani For patient information, click here Distal radius fracture Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Distal radius fracture from other Diseases Epidemiology and [wikidoc.org]
Pathophysiology The pathophysiology of cor pulmonale is a result of increased right-sided filling pressures from pulmonary hypertension that is associated with diseases of the lung.[5][6][7] Under normal physiologic conditions, the right ventricle pumps [ncbi.nlm.nih.gov]
Although cor pulmonale commonly has a chronic and slowly progressive course, acute onset or worsening cor pulmonale with life-threatening complications can occur. [1] Etiology and Pathophysiology of Cor Pulmonale The pathophysiology of cor pulmonale is [emedicine.medscape.com]
Prevention
It permits minimally limited flexion of the wrist but prevents wrist dorsiflexion. It makes impossible any radial deviation. [ncbi.nlm.nih.gov]
[…] to prevent joint stiffness. (2) Fact Explanation intra-medullary K-wire fixation stabilize the distal radius and prevention of secondary displacement of distal radial fractures, k wires are inserted to intramedullary canal manually.(1) intra-medullary [medicaljoyworks.com]
Therefore, prevention of distal radius fractures in older people should focus on prevention of osteoporosis and risk factor reduction. [orthopaedicsone.com]