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What is "Dinner-fork" deformity is seen in Fracture of____ and explain in detail?
Ans. a (Radius) (Ref. Maheshwari orthopedics 4th/93)COLLES' FRACTUREFracture at the distal end of radius at corticocancellous junction about 2 cm from distal articular surface in adults with displacements as follows:# Dorsal displacement# Dorsal tilt# Impaction of fragments (Mnemonic: DDILLS)# Lateral displacement# Lateral tilt# SupinationFollowing are the common injuries associated with Colies fracture:# Fracture styloid process of ulna# Ulnar collateral ligament rupture# Rupture of triangular cartilage of ulna# Rupture of interosseous radioulnar ligament, producing radioulnar subluxation.Clinical Features & X-ray# Dinner fork deformity# Dorsal tilt is the most characteristic displacement (normally distal articular surface faces ventrally).# Most displacements can be identified on X-ray except for supination of the distal fragment, which can be appreciated only clinically.Rx:# Essentially conservative# Undisplaced fracture = immobilization below elbow cast for 6 weeks# Displaced fracture = manipulative reduction followed by immobilization in Colles' cast (Shaking hand type).# In communited fractures = better is percutaneous transfixation of K wires incorporated in plaster cast.Complications n Stiffness of joints (most common complication)# Malunion# Subluxation of inferior radioulnar joint# Carpal tunnel syndrome# Sudeck's osteodystrophy (Colles' fracture is the most common cause)# Rupture of Extensor pollicis longus tendonAlso Know:Smith's Fracture Barton's Fracture# It is reverse of Colles' fracture0# Uncommon# Garden spade deformity0# Differ's from Colles' in that:- Distal fragment displaced ventrally and tilts ventrally# Rx is by closed reduction and plaster immobilization for 6 weeks.# Fractutre extends form the distal articular surface of radius to either its anterior or posterior cortices.- Volar Barton: anterior marginal type- Dorsal Barton: posterior marginal type# Rx: Closed manipulation and plaster cast.