![]() In order to make a diagnosis of these injuries, X-rays of the wrist in two positions are usually necessary, one perpendicular to the other, that is, posterior–anterior and lateral, including the metacarpophalangeal and distal joints in relation to the injury. This will allow us to determine which fractures are susceptible to orthopedic treatment, and which require surgical treatment. The established criteria to determine displacement of a fracture are: shortening greater than 5 mm, angulation greater than 20° in any direction, an articular step of 2 mm, presence of dorsal comminution, or severe osteoporosis. When a fracture is considered to be displaced is when we ought to perform additional treatment. That said, we know that there may be displacement of fractures, and that these can be called by different acronyms simply based on their displacement. These injuries occur more often among women (with a 7:1 ratio) there is also a correlation with osteopenia and/or osteoporosis however, it can also occur in healthy bones. These types of fractures are usually caused by a fall from a standing position onto an outstretched arm (Colles’ fracture) or hyperflexion (Smith's fracture), and radial or cubital deviation which result in different types of fracture traces and displacements. Depending on the amount of energy required to cause it, it may result in a simple fracture trace, fracture-luxation or a comminuted fracture (presence of several fragments). Among the descriptions, there is the (a) intra-articular fracture: which is a fracture that extends into the radiocarpal or distal radio-ulnar articulation, the (b) extra-articular fracture, when the fracture trace does not extend into the articulations, the (c) open fracture, that is, when there is a skin lesion, exposing the fracture to the outside, and may be considered contaminated or partially infected, and closed fracture, where there is no skin lesion. 1Īnother way of describing these fractures may be by the involvement of articulations or soft tissues. This fracture is, as described by its name, a fracture of the distal radius associated with a dislocation of the radiocarpal joint, either volar or dorsal. Last but not least, there is the Barton's fracture/dislocation (John Rhea Barton 1794–1871), which may be volar or dorsal. ![]() Among the other fractures related to this zone, there is the Chauffeur fracture (or Hutchinson-Jonathan Hutchinson 1828–1913), which refers to fracture of the radial stylus with or without additional displacement another type is the “die punch” fracture, which represents an intra-articular fracture of the lunate fossa of the distal radius. Within this type, we are able to identify the “dinner fork” deformity, which implies that its displacement is dorsal the Smith fracture (Robert William Smith 1807–1873), often called a reverse Colles fracture, with an inverse “dinner fork” deformity, which represents a distal radius with volar displacements of fragments. There is the Poteau-Colles fracture (better known as Colles fracture), first described in 1814 by the Irish surgeon and anatomist Abraham Colles (1773–1843) and Claude Pouteau (1725–1775) in France. These, according to their displacement or tracing of the fracture, may be known by different names. Distal radius fractures are those which by definition occur about one inch from the end of the bone.
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