![]() ![]() Suddenly, a seemingly common and simple fracture to treat was becoming more complex than splitting an atom, not to mention extremely expensive. Not surprisingly, these surgeons also had a financial stake in the companies providing the equipment. ![]() Not only was this approach technology-driven, but certain surgeons were only too happy to present their expertise in this ever-complex surgery, and promote themselves in the process. It got to the point where surgeons were putting up to three plates, one on the front, one on the back and one on the side of the bone to fix the fracture as perfectly as possible. Of course, the companies that manufacture the hardware were more than happy to drive this trend. It was driven by two factors: the drive to fix the fracture as perfectly as possible and the technology in the form of new hardware to accomplish this. As well as providing better-looking x-rays and cosmetic improvements in the contour of the wrist, radiographic studies demonstrated that the frequency of wrist arthritis was directly correlated to improved alignment of the fracture fragments, which was possible with surgical treatment.Īn explosion of different operative techniques and equipment to fix these fractures came along in the 90s. In the late 1970’s fluoroscopy (real time x-ray) as well as studies showing cast treatment to be sub-optimal led to the development of surgical treatments for these fractures. This process was time consuming and often unpleasant for the patient. Weekly x-rays were required because the fracture tended to displace back to its original deformity, and multiple manipulations over the course of treatment were usually necessary. ![]() To hold the bone in place the cast was typically flexed at the wrist and went above the elbow. A physician would numb the fracture, manipulate the bone back into place, and cast it. Prior to the mid-1970s, treatment of this fracture was pretty uniform. You’d think something so common would have a consistently recommended treatment, but the fact is, depending on where you live and the physician you see, treatments vary widely and there is no single best treatment identified. Keep that image in mind as I discuss treatment. The force is directed to the distal radius and the bone fractures, resulting in a “dinner fork” deformity of the wrist, with the bend being the distal radius and the prongs being the fingers. Typically, this fracture occurs when someone lands on their outstretched arm during a fall. The Colles Fracture, named after Sir Abraham Colles, who first described the injury in 1814, is a fracture of the distal radius (the long bone of the forearm on the thumb side) and is the most common fracture treated by orthopaedic surgeons in North America. ![]()
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