Colles' Fracture: Distal Radius Fracture – Mechanism, Diagnosis, Treatment

A Colles' fracture is a distal radius fracture with dorsal displacement and angulation (dinner-fork deformity), typically from a fall on an outstretched hand (FOOSH) with wrist in dorsiflexion.

Eponym

Named after Abraham Colles (Irish surgeon, 1814), who described it before X-rays existed.

Key Features

• Extra-articular (usually) or intra-articular.
• Dorsal angulation >10°, radial shortening, radial inclination loss.
• Often with ulnar styloid fracture.

Diagnosis

• Clinical: dorsal deformity, swelling, tenderness, limited ROM.
• X-ray: PA, lateral, oblique – confirm displacement, articular involvement.

Treatment

• Closed reduction + cast/splint (if reducible, stable, extra-articular, low-demand patient).
• Percutaneous pinning / external fixation – unstable, intra-articular.
• ORIF (volar plate) – gold standard for displaced, intra-articular, unstable fractures; allows early mobilization.

Complications

• Malunion (residual deformity, stiffness).
• Post-traumatic osteoarthritis.
• Complex regional pain syndrome (CRPS).
• Median neuropathy (acute or delayed).

Most common fracture in adults >60 (osteoporosis).