Diagnosis

Extraarticular fracture radius, simple and impacted

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Clinical examination

The patient should be evaluated for:

• Age
• Hand dominance
• Occupation
• Level of activity
• Quality of bone
• General medical condition

Options
1.  Undisplaced
2.  With dorsal displacement or tilt (Colles)
3.  With volar displacement or tilt (Smith's)

1.  Undisplaced

Simple fracture of the radius, with no tilt

These fractures involve only the radial metaphysis without involving the radiocarpal, or the distal radioulnar joints. They may be undisplaced, or impacted, but exhibit no abnormal palmar or dorsal tilt.

These are classified by AO/OTA as 2R3A2.1.

There may be an associated ulnar injury. This is usually a fracture of the ulnar styloid process, but other ulnar fractures are possible.

Simple fracture of the radius, with no tilt view

2.  With dorsal displacement or tilt (Colles)

Simple extraarticular fractures with impaction and dorsal tilt are often referred to as Pouteau or Colles fractures. They are usually stable in their displaced position, which may or may not be acceptable.

These are classified by AO/OTA as 2R3A2.2.

There may be an associated ulnar injury. This is usually a fracture of the ulnar styloid process, but other ulnar fractures are possible.

Extraarticular fracture of the radius with dorsal displacement or tilt (Colles) X-rays

X-rays taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.

3.  With volar displacement or tilt (Smith's)

Extraarticular radial fracture with volar displacement or tilt (Smith's)

Simple extraarticular fractures with a palmar tilt are often referred to as Goyrand-Smith fractures. These fractures are significantly less stable than the dorsally displaced fractures.

These are classified by AO/OTA as 2R3A2.3.

There may be an associated ulnar injury. This is usually a fracture of the ulnar styloid process, but other ulnar fractures are possible.

Extraarticular radial fracture with volar displacement or tilt (Smith's) X-rays

X-rays taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.