Distal Radius Fracture
Distal radius fracture is the most common orthopedic injury. Here's a quick summary.
• Fracture at the metaphysis or articulation of distal radius
• Most common orthopedic injury
• Eponyms:
• Colles (90% "dinner fork") = dorsally displaced. extra-articular
• Smith ("reverse Colles") = volar displaced. extra-articular
• Barton = intra-articular dorsal or volar (more common) rim fracture
• Chauffer = radial styloid fracture
• Mechanism: Fall onto outstretched hand
• Exam: variable gross wrist deformity with decreased ROM
• Possible associated injuries: DRUJ disruption, radial styloid fracture, median nerve injury, acute carpal tunnel syndrome, soft tissue injuries (TFCC injury, scapholunate and/or lunotriquetral ligament injury)
• ED Management: Hematoma block +/- procedural sedation and reduction using finger traps
• Splint: Sugar tong
• Ortho consult:
No if Colles or Chauffer unless unable to reduce;
Yes if Smith or Barton
• Disposition: DC home if Colles or Chauffer with orthopedic follow-up within I week; Smith or Barton, pending orthopedic recommendations
MH/CCF/CWRU EM Res @MetroHealth_EM
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