Consequence of various wrist angulations at impact on the severity of Colles’ fractures (922.4)

Abstract

A Colles’ fracture, eponymously named after Irish surgeon Abraham Colles, is a transverse break of the distal radius (2.5 cm from the radio‐carpal joint) with dorsal displacement of the carpus and hand. It is most commonly a consequence of falling onto outstretched hands. As the exact angle of the wrist changes with each fall, this study tested for correlation between wrist angulation at impact and the severity of the resulting Colles’ fracture. A sample of 15 cadaveric upper limbs exhibiting no evidence of traumatic injuries on gross observation was used to study this relationship. Specimens were cut transversely at mid‐forearm and randomly assigned to either the 90 degree wrist extension group (n=7) or the 45 degree wrist extension group (n=8). Specimens were secured and a drop‐weight impactor was used to apply force to the extended palms, recreating a scenario of falling. After impact, each specimen was radiographed and assessed for evidence and severity of fracture graded via Frykman’s classification system. Results showed that falling with the wrist extended 90 degrees was more likely to produce a Colles’ fracture while falling onto a wrist extended 45 degrees produced extensive damage to the ulna and carpus. Better understanding of the relationship between carpal angulation and likelihood/severity of fractures may aid preventative approaches for populations at high‐risk for falls such as the elderly and athletes.Grant Funding Source: Supported by SUNY Downstate Alumni Association