colles

Colles fracture refers to a distal radius fracture with dorsal displacement of the distal fragment, typically resulting from a fall on an outstretched hand. It is named after Abraham Colles, who first described the injury in 1814. The typical mechanism is low-energy trauma in older adults, especially those with osteoporosis, but a higher-energy fall can occur in younger people as well. The resulting deformity—often described as a dinner- fork deformity—is due to dorsal angulation and impaction of the distal radius.

Clinically, patients present with abrupt wrist pain, swelling, and limited motion after the fall. The deformity is usually evident on inspection and confirmed by imaging. Plain radiographs (anteroposterior and lateral views) show a dorsally displaced distal fragment with possible comminution; intra-articular extension and associated injuries may occur. Distal radius fractures are classified by displacement and articular involvement, with more complex schemes in use (for example, Frykman or AO/OTA systems) to guide management. Colles fractures are generally considered extra-articular when the fracture line does not involve the radiocarpal joint.

Treatment aims to restore anatomical alignment and function. Nonoperative management is common for stable, nondisplaced fractures or in patients for whom surgery carries high risk; this typically involves closed reduction followed by immobilization in a synthetic or plaster cast for several weeks. Unstable, displaced, or intra-articular fractures, or those with neurovascular compromise, often require surgical fixation, such as open reduction and internal fixation with a volar locking plate, dorsal plating, or external fixation. Rehabilitation begins after immobilization to restore range of motion and strength. Complications can include malunion, stiffness, persistent deformity, median nerve compression, and, less commonly, post-traumatic arthritis or complex regional pain syndrome. The prognosis is usually favorable with appropriate treatment, though functional outcomes may be reduced in the elderly with osteoporosis.