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At least 19 recordsLinked to original sources
PubMed1992

[A study of risk factor in osteoporosis, femoral neck fracture and colles' fracture].

This work studied risk factors of osteoporosis, femoral neck fracture and Colles' fracture. The results were compared with those of a healthy group. Milk intake was frequent in the healthy group, but rare in the femoral neck fracture or Colles' fracture group. Most of osteoporosis and femoral neck fracture group were bed ridden, or stayed indoors for a long time before injury. They weighed less and were thin as compared to the healthy group. Decrease of activities of daily living and less body weight were risk factors of osteoporosis and femoral neck fracture, but these risk factors were more predominant in the femoral neck fracture than osteoporosis group. In this study, 74.4% of the patients with femoral neck fracture also had osteoporosis and 33.3% with Colles' fracture had osteoporosis. Colles' fracture was related to injury force and femoral neck fracture was found to be closely related to osteoporosis.

Activities of Daily Living↗
PubMed1996

Acute compartment syndrome complicating Colles' fracture.

Colles' fracture is a common injury and has a relatively high associated morbidity. Compartment syndrome is a rare complication, but a high index of suspicion must be maintained in the initial post-injury and post-reduction periods.

Acute Disease↗
PubMed1991

[Basket wires--a percutaneous surgical procedure for the treatment of unstable Colles' fractures].

Colles fractures are usually treated with closed reduction and forearm plaster. Even if reduced perfectly, some of these fractures tend to redislocate dorsally and radially, requiring repeated reduction maneuvers. Since K-wires cannot be firmly anchored in the distal fragment if comminution exists, Kapandji proposed a method whereby the distal fragment is not pinned at all. He introduced the pins through the fracture itself and into the medullary canal of the proximal fragment, anchoring the wires into the opposite cortices of the radius shaft. In order to "pre-stress" the K-wires, Böhler and Zifko modified the technique and the wires themselves. They inserted the wires through small skin incisions into the fracture and into the proximal fragment as medullary pins. The specially bent pins glide smoothly into the medullary cavity and snugly fit along the distal fragment; thereby minimizing the chance of damaging extensor tendons. One pin is inserted proximal to Lister's tubercle and another radially, proximal to the radial styloid. Technique, indication, and possible technical errors are discussed based on the follow-up of forty one patients.

Adult↗
PubMed1997

[Biomechanics of combined Kirschner wire osteosynthesis in the human model of unstable dorsal, distal radius fractures (Colles type)].

In an experimental study, the biomechanical qualities of the combined Kirschner wire osteosynthesis (KWO) in the unstable Colles' fracture were analyzed. This type of pin fixation is our preferred osteosynthesis in the treatment of unstable Colles' fracture because it allows immediate functional therapy. It represents a modification of Kapandji's dynamic KWO, compensating for the insufficient volar stability by means of the conventional static KWO. Clinical experience according to the anatomical and functional results, was very encouraging suggesting that a clinical concept based on the biomechanical principles of combined KWO and its single components should be constituted. Simulation of the unstable Colles' fracture was realized by dorsal wedge osteotomy of the distal end of the radius using cadaveric material. This fracture model was subsequently pinned using the different KWO types and tested by a standardized vector energy testing device regarding its stability in the four main loading directions. The combined KWO unifies the advantage of volar stability of the conventional KWO with the high dorsal stability of dynamic KWO. The main functional principle of dynamic KWO with regard to its axial stability consists in the repositioning of the dorsal bone fragmentation zone and hence the reconstitution of cortical load transmission. Besides its good stabilization, dynamic KWO also leads to optimal alignment of the distal metaphyseal fragment. Furthermore, the experiments yielded important information about technical aspects of the surgical procedure, which helps us to avoid anatomical and functional deficiencies. Based on these experimental findings, the surgical technique of combined KWO was standardized.

Biomechanical Phenomena↗
PubMed1993

Computer-assisted prediction of the instability of Colles' fractures.

Many Colles' fractures are unstable and have a tendency to redisplace when immobilised in plaster. In an earlier study, we found a high correlation between several parameters from the initial radiographs in 267 patients and the anatomical end results. The predictive power of a new computer programme designed from the data of these patients was investigated in a further group of 107 Colles' fractures. Prediction of the final radiological position was good, especially in the least and moderately displaced fractures. We have found that the initial radial shortening, the type of fracture according to Lidström's classification, and the age of the patients have the greatest value in predicting whether a Colles' fracture will displace to an unacceptable degree.

Aged↗
PubMed1987

The value of early mobilisation in the treatment of Colles' fractures.

Unilateral Colles' fractures in 187 patients over the age of 55 years were studied in a randomised prospective trial: 97 fractures were minimally displaced and were treated either conventionally or in a crêpe bandage; 90 displaced Colles' fractures were reduced and of these 47 were treated conventionally while 43 were encouraged to mobilise the wrist in a cast which restricted extension. Early wrist movement hastened functional recovery and led to earlier resolution of wrist swelling. Discomfort was no greater than in patients who were treated conventionally. The bony deformity, which recurred irrespective of the method of treatment, was not adversely affected by early mobilisation.

Aged↗
PubMed1980

Complications of Colles' fractures.

Patients with Colles' fractures have serious complications more frequently than is generally appreciated. A study of 565 fractures revealed 177 (31 per cent) with such complications as persistent neuropathies of the median, ulnar, or radial nerves (forty-five cases), radiocarpal or radio-ulnar arthrosis (thirty-seven cases), and malposition-malunion (thirty cases). Other complications included tendon ruptures (seven), unrecognized associated injuries (twelve), Volkmann's ischemia (four cases), finger stiffness (nine cases), and shoulder-hand syndrome (twenty cases). In many patients, incomplete restoration of radial length or secondary loss of the reduction position caused the complications.

Arthritis↗
PubMed1993

Midazolam sedation for the reduction of Colles' fractures.

The treatment of Colles' fractures in the elderly comprises a heavy workload for both accident and orthopaedic departments. The initial management has important clinical and financial implications for patient and hospital. The demand is variable and the ability to respond must also be flexible. The choice of anaesthetic technique is therefore most important. In our experience, intravenous sedation with midazolam (a water soluble benzodiazepine) has proven to be safe and effective in providing good conditions for anatomical reduction of Colles' fractures on an outpatient basis.

Aged↗
PubMed1987

A rational approach for the recognition and treatment of Colles' fracture.

The approach to Colles' fracture, as recommended in this article, is derived from understanding the mechanism of injury. Fractures that are inherently unstable can be recognized by observing the depth of comminution presented on the lateral postreduction radiography. These unstable fractures demand a more vigorous approach to achieve the result our patients have come to demand. External fixators, percutaneous pinning, and bone grafting have all been successfully used to achieve a satisfactory result. Fortunately, the majority of Colles' fractures are stable and can be treated by accurate closed reduction and immobilization in plaster. If the fracture results in loss of containment of the carpus, a chronically weak and sometimes painful wrist will result. This event can be remedied surgically. The final emphasis I would like to impart is the prevention of sympathetic reflex dystrophy. Early involvement by the patients in their rehabilitation process is essential in minimizing this condition. Understanding and application of the principles I have presented will result in patients pleased with the result of their care and, consequently, with their physician.

Arthritis↗
PubMed1994

[Colles fracture and instability of wrist joint].

We reviewed 51 cases of colles fracture patients with 3-6 years follow-up and found 20 cases had dorsal carpal subluxation (DCS) in this group. Long term results were analysed and compared between the simple Colles fracture and the Colles fracture with DCS. It was shown that the remote function of the wrist in the simple Colles fracture was much more satisfactory than in that with DCS. That indicated the DCS is a very important factor to the late results of the wrist after Colles fracture. The authors pointed out that the DCS occurs frequently in the severely displaced type caused by high energy force and in the fracture associated with scapholunate dissociation. During the close reduction of the Colles fracture associated with DCS, correction of the palmar angulation and decrease of the angle of palmar tilt should be required, as well as the neutral or light dorsal flexion fixation of the wrist after reduction.

Adult↗
PubMed1991

Factors associated with Colles' fracture in the elderly.

We have measured sway, hearing and eyesight in a group of elderly patients with Colles' fracture (3 males, 21 females, mean age 75.9 years) and in a control group of elderly fallers (5 males, 19 females, mean age 76.9 years) who had no fractures. The Colles' fracture group had better eyesight than the control group (p = 0.022), but worse hearing, particularly at lower frequencies (p less than 0.0001 at 500 Hz), suggesting a conductive hearing loss. We conclude that those individuals with better eyesight would try to stretch their arm to break a fall, so breaking their wrist. Osteoporotic changes in the auditory ossicles is proposed as a possible cause for the hearing loss in the Colles' fracture group. We conclude that those individuals presenting with Colles' fracture may also have hearing loss and conversely, patients presenting with a conductive hearing loss may be at risk of developing the further symptoms of osteoporosis.

Accidental Falls↗
PubMed1987

Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia.

To investigate whether or not injection of local anesthetic into the fracture hematoma on reduction of a Colles' fracture increases the risk of neurological complications, a prospective randomized trial was conducted. The outcome in 62 patients whose Colles' fractures were reduced in a new bone-alignment device without anesthesia was compared with that in 54 patients with Colles' fractures that were reduced manually after injection of local anesthetic. At follow-up, any symptoms and signs of nerve damage were recorded. Four cases of such damage were noted in the group treated without local anesthesia, as opposed to 14 in the group in which a local anesthetic was used. The difference is significant (p less than 0.01). The authors have previously shown that injection of local anesthetic into the hematoma of Colles' fractures increases the carpal tunnel pressure. Neurological complications after the use of local anesthesia in reducing Colles' fractures is considered to be secondary to the scarring and fibrosis caused by this increase in pressure.

Adult↗
PubMed1988

Late compression neuropathies after Colles' fractures.

Conservative management of 166 Colles' fractures was associated with a 12% rate of late compression neuropathies (mean follow-up period, 28 months). Compression of the median nerve (8%) was twice as common as ulnar nerve compression (4%). Eighty-five percent of the patients with median nerve compression had malunion with radial collapse with or without other deformities (dorsal angulation/radial displacement). Patients with ulnar nerve compression had either malunion with radial collapse or volar subluxation of the ulnar head in those fractures that healed with dorsal angulation. Patients without nerve complications showed a significantly lower rate of malunions. These results demonstrate that anatomic derangements play a role in the development of late compression neuropathies following Colles' fractures.

Adolescent↗
PubMed1989

Carpal malalignment in Colles' fractures.

Thirty-two unilateral Colles' fractures were reviewed after one year to assess the evidence for carpal malalignment. Various radiographic parameters on the injured and uninjured wrists were correlated with a functional score. There was significant correlation with respect to the angles measuring carpal alignment on the late films and the functional score which was not present on either the initial or post-manipulation films. The carpus aligns in a dorsal instability pattern. Radial angulation or shortening was not found to be as significant in either the early or late films. This suggests that dorsal instability as the cause of morbidity after Colles' fracture is far commoner than originally thought.

Aged↗
PubMed1992

Percutaneous Kirschner wire stabilisation following closed reduction of Colles' fractures.

32 consecutive unstable Colles' fractures were treated by closed reduction and percutaneous Kirschner wire stabilisation through the radial styloid, followed by a below-elbow cast. Radiological assessment was made at five stages of treatment: at the time of the fracture, immediately after operation, after two weeks, after six weeks and a final review at an average period of 15.9 months. Functional assessment was made at the final review. Only three fractures developed secondary displacement, which was due to the wrong placement of the Kirschner wire. There were no complications.

Adult↗
PubMed1989

Brace treatment of Colles' fracture.

Twenty patients with Colles' fractures were treated with a functional brace that allows wrist motion. The result was compared with a similar group of patients treated with a plaster cast. Dorsal displacement of the fracture was less and wrist function was better in the brace group. Swelling of the hand during the early stages was observed in the brace group; and because this may necessitate brace adjustment, increased medical supervision is necessary for this period.

Adult↗