Collesfraktur

Collesfraktur, or Colles fracture, is a distal radius fracture in which the distal fragment is displaced dorsally and angulated, producing a characteristic dinner-fork deformity on lateral radiographs. It is named after Abraham Colles, who described the injury in the early 19th century. The fracture typically results from a fall on an outstretched hand and is most common in older adults with osteoporosis, particularly women, though it can occur at any age.

Clinically, it presents with acute wrist pain, swelling, and deformity. The patient may have limited wrist motion and tenderness around the distal radius. Median nerve symptoms can occur if swelling or displacement compresses the nerve, and signs of vascular compromise are uncommon.

Radiographs show dorsal tilting and shortening of the distal fragment, with changes in radial length and inclination. The fracture may be extra-articular or involve the radiocarpal joint (intra-articular). Fractures are commonly classified using systems such as Frykman or AO/OTA, with Colles fractures typically described as distal radius fractures that are extrarticular or minimally articular.

Treatment is guided by stability and articular involvement. Nonoperative management is common for stable, extra-articular fractures and includes closed reduction followed by immobilization in a cast or splint (often a sugar-tong or forearm cast) for about 5–8 weeks, with early mobilization of the fingers and elbow. Unstable, intra-articular, or significantly displaced fractures may require operative fixation, such as percutaneous pinning, external fixation, or volar locking plate fixation. Osteoporosis assessment and fall-prevention strategies are important components of management.

Complications can include malunion with persistent dorsal tilt and deformity, stiffness, complex regional pain syndrome, median nerve compression, and post-traumatic osteoarthritis. Recovery generally progresses with time and rehabilitation.