Pediatric Colles Fracture

  • Etiology: Fall on outstretched hand
  • Imaging:
    — Extra-articular fracture of distal radial metaphyseal region with dorsal angulation and impaction but without the involvement of articular surface
    — Ulnar styloid fracture also in up to 50%
  • DDX: Smith fracture which is extra-articular fracture of distal radial metaphyseal region with volar angulation
  • Complications:
    — Malunion resulting in dinner fork deformity
    — Median nerve palsy and post-traumatic carpal tunnel syndrome
    — Reflex sympathetic dystrophy
    — Secondary osteoarthritis: more frequently seen in patients with intra-articular involvement
    — Extensor pollicis longus tendon tear: more common in non-displaced fractures
  • Treatment: Usually closed reduction and cast immobilization
  • Clinical:

Radiology Cases of Colles Fracture

Radiograph of Colles fracture
AP and lateral radiographs of the wrist show a comminuted distal radius metaphyseal fracture with dorsal angulation of the distal fracture fragment.
Radiograph of Colles fracture
AP radiograph of the wrist (left) shows an extra-articular fracture of the distal radial metaphyseal region while the lateral (right) shows dorsal angulation and impaction of the distal fracture fragment without the involvement of the articular surface.