LONG-TERM FOLLOW UP OF COLLES’S FRACTURES

Abstract

The purpose of this study is to review the current treatment of Colles fractures by long term follow up and to compare these results with a similar paper published in 1965 by G.B. Smail. And secondly, to evaluate the degree of bone density in these patients and to see what, if any, treatment is being received in those with evidence of osteopenia.

The records and radiographs of 82 patients treated at Hutt Hospital between January 1997 and January 1998 were reviewed. Of these, thirty-two attended for re-examination. Subjective measures of pain, appearance and functional limitations were recorded, as were complications and whether the wrist had reached a stable state.

Anterior-posterior and lateral radiographs of both wrists were taken, from which measurements of residual dorsal tilt and shortening of radius were made.

Of the thirty two patients that presented for re-examination twenty went on to have bone density measurements.

When comparing results from two similar studies, spaced thirty seven years apart, subjective findings show that from a functional and appearance perspective there appears to be little difference between the two cohorts. With respect to pain, patients treated in 1997 complained of a lot less residual pain compared to those treated in 1960.

Objectively, the range of movement in the wrist joint was once again found to be similar in the two cohorts, as was the range of movement in shoulder, elbow appeared to be similar. Finger movement was difficult to compare.

Radiologically the degree of ventral dorsal tilt does not correlate with range of movement at the wrist.

Bone density scan results suggest that the majority of patients with evidence of osteoporosis are not been treated appropriately.

Overall conclusion is that the outcome for treatment of Colles’s fractures has not changed significantly in the past thirty seven years.