J Korean Fract Soc.  2008 Jan;21(1):81-86. 10.12671/jkfs.2008.21.1.81.

Osteoporotic Distal Radius Fracture-conservative Treatment

• Song SW

• KMID: 1480970
• DOI: http://doi.org/10.12671/jkfs.2008.21.1.81

Abstract

No abstract available.

MeSH Terms

Radius

Figure

• 

  Fig. 1 Algorithm of the treatment of distal radius fracture by AO Classification9).

• 

  Fig. 2 Over tight cast prevents the finger exercise and causes swelling and edema of fingers, leading to reflex sympathetic dystrophy.

• 

  Fig. 3 (A) Unless there is severe bone loss or osteoporosis at the fracture site of distal radius the initial sugar-tong cast usually prevents forearm rotation and the further displacement. (B) After 3~4 weeks the initial cast is changed with short arm cast.

• 

  Fig. 4 Direct manipulation without enough longitudinal traction is forbidden. To reduce the fracture site a gentle steady longitudinal traction must be preceded before the manual reduction of fracture site.

• 

  Fig. 5 Chinese finger trap can be used to ease the reduction. During the steady traction the distal fragment is pushed to the opposite direction from the initial displaced site.

Reference

1. Abbaszadegan H, von Sivers K, Jonsson U. Late displacement of Colles' fractures. Int Orthop. 1988; 12:197–199.

2. Atkins RM, Duckworth T, Kanis JA. Features of algodystrophy after Colles' fracture. J Bone Joint Surg Br. 1990; 72:105–110.

3. Bacorn RW, Kurtzke JF. Colles' fracture: a study of two thousand cases from the New York State Workmen's Compensation Board. J Bone Joint Surg Am. 1953; 35:643–658.

4. Colles A. On the fracture of the carpal extremity of the radius. Edinb Med Surg J, 1814;10:181. Clin Orthop Relat Res. 2006; 445:5–7.

5. Cooney WP. Fractures of the distal radius. A modern treatment-based classification. Orthop Clin North Am. 1993; 24:211–216.

6. Cooney WP. Fractures of the distal radius. In : Cooney WP, Linscheid RL, Dobyns JM, editors. The wrist: diagnosis and operative treatment. 1st ed. St Louis: Mosby Inc;1998. p. 310–384.

7. Cooney WP, Agee JM, Hastings H, et al. Symposium: management of intra-articular fractures of the distal radius. Contemp Orthop. 1980; 21:71–104.

8. Crilly RG, Delaguerriere Richardson L, Roth JH, vandervoort AA, Hayes KC, Mackenzie RA. Postural instability and Colles' fracture. Age Ageing. 1987; 16:133–138.

9. Fernandez DL, Jupiter JB. Fractures of the distal radius. 2nd ed. New York: Springer-Verlag;2002. p. 71–186.

10. Freedman BA, Potter BK, Nesti LJ, Cho T, Kuklo TR. Missed opportunities in patients with osteoporosis and distal radius fractures. Clin Orthop Relat Res. 2007; 454:202–206.

11. Frykman G. Fracture of the distal radius including sequelae-shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand. 1967; Suppl 108. 3+.

12. Gardner MJ, Flik KR, Mooar P, Lane JM. Improvement in the under-treatment of osteoporosis following hip fracture. J Bone Joint Surg Am. 2002; 84:1342–1348.

13. Gartland JJ Jr, Werley CW. Evaluation of healed Colles' fracture. J Bone Joint Surg Am. 1951; 33:895–907.

14. Gellman H. Fractures of the distal radius. In : Gellman H, editor. Fractures of the distal radius. 1st ed. Rosemont: AAOS;1998. p. 1–36.

15. Jupiter JB. Fractures of the distal end of the radius. J Bone Joint Surg Am. 1991; 73:461–469.

16. Kim BS, Kim WJ, Lee KW, et al. Reduction loss after treatment of distal radius fracture. J Korean Soc Surg Hand. 2003; 8:99–104.

17. Kirschen AJ, Cape RDJ, Hayes KC, Spencer JD. Postural sway and cardiovascular parameters associated with falls in elderly. J Clin Exp Res Gerontol. 1984; 6:291–307.

18. Lauritzen JB, Schwarz P, Lund B, McNair P, Transbol I. Changing incidence and residual lifetime risk of common osteoporosis-related fractures. Osteoporos Int. 1993; 3:127–132.

19. McQueen M, Caspers J. Colles' fracture: does the anatomical result affect the final function? J Bone Joint Surg Br. 1988; 70:649–651.

20. Melone CP Jr. Articular fractures of the distal radius. Orthop Clin North Am. 1984; 15:217–236.

21. Nguyen T, Sambrook P, Kelly P, et al. Prediction of osteoporotic fractures by instability and bone density. BMJ. 1993; 307:1111–1115.

22. Owen RA, Melton LJ 3rd, Johnson KA, Ilstrup DM, Riggs BL. Incidence of Colles' fracture in a North American community. Am J Public Health. 1982; 72:605–607.

23. Porter M, Stockley I. Fractures of the distal radius. Intermediate and end results in relation to radiologic parameters. Clin Orthop Relat Res. 1987; 220:241–252.

24. Sarmiento A, Pratt GW, Berry NC, Sinclair WF. Colles' fracture. Functional bracing in supination. J Bone Joint Surg Am. 1975; 57:311–317.

25. Simic PM, Weiland AJ. Fractures of the distal aspect of the radius: Changes in treatment over the past two decades. Instr Course Lect. 2003; 52:185–195.

26. Solgaard S. External fixation or a cast for Colles' fracture. Acta Orthop Scand. 1989; 60:387–391.

27. Steward HD, Innes AR, Burke FD. Factors affecting the outcome of Colles' fracture: an anatomical and functional study. Injury. 1985; 16:289–295.

28. Suh JT, Kim DW, Yoo CI. Surgical treatment of fractures of the distal radius in patients older than 65 years. J Korean Soc Fract. 2003; 16:563–569.

29. Taleisnik J, Watson HK. Midcarpal instability caused by malunited fractures of the distal radius. J Hand Surg Am. 1984; 9:350–357.

30. Weber ER. A rational approach for the recognition and treatment of Colles' fracture. Hand Clin. 1987; 3:13–21.

31. Wigderowitz CA, Cunningham T, Rowley DI, Mole PA, Paterson CR. Peripheral bone mineral density in patients with distal radius fractures. J Bone Joint Surg Br. 2003; 85:423–425.