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About Of ๐˜พ๐™ค๐™ก๐™ก๐™š๐™จ ๐™›๐™ง๐™–๐™˜๐™ฉ๐™ช๐™ง๐™š !!

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Writer : Ishrat Purobi

๐˜พ๐™ค๐™ก๐™ก๐™š๐™จ’ ๐™›๐™ง๐™–๐™˜๐™ฉ๐™ช๐™ง๐™š:

เฆฌเงŸเฆธเงเฆ• เฆฌเงเฆฏเฆ•เงเฆคเฆฟเฆฆเง‡เฆฐ เฆนเฆพเงœ เฆญเฆพเฆ™เฆพเฆฐ เฆฎเฆงเงเฆฏเง‡ เฆธเฆฌเฆšเง‡เงŸเง‡ เฆฌเง‡เฆถเฆฟ เฆชเฆพเฆ“เงŸเฆพ เฆฏเฆพเงŸ Colles’ fracture. เฆฌเฆฟเฆถเง‡เฆท เฆ•เฆฐเง‡ เฆฏเฆพเฆฐเฆพ Postmenopausal women. เฆคเฆพเฆฆเง‡เฆฐ bones เฆธเฆพเฆงเฆพเฆฐเฆฃเฆค Osteoporotic เฆนเงŸเง‡ เฆฅเฆพเฆ•เง‡เงท
๐˜ผ๐™—๐™ง๐™–๐™๐™–๐™ข ๐˜พ๐™ค๐™ก๐™ก๐™š๐™จ ๐™ž๐™ฃ 1814, described ๐˜พ๐™ค๐™ก๐™ก๐™š๐™จ’ ๐™›๐™ง๐™–๐™˜๐™ฉ๐™ช๐™ง๐™š as

“It is transverse fracture radius 2 cm proximal to the distal articular surface of the radius with dorsal displacement of the distal fragment.”

เฆเฆ‡ fracture เฆเฆฐ เฆ•เฆฟเฆ›เง Criteria เฆ†เฆ›เง‡เฅค เฆฏเง‡เฆฎเฆจ-
โ˜…๐™พ๐š•๐š ๐š•๐šŠ๐š๐šข
โ˜…๐™ฟ๐š˜๐šœ๐š ๐š–๐šŽ๐š—๐š˜๐š™๐šŠ๐šž๐šœ๐šŠ๐š• ๐š ๐š˜๐š–๐šŽ๐š—
โ˜…๐™พ๐šœ๐š๐šŽ๐š˜๐š™๐š˜๐š›๐š˜๐š๐š’๐šŒ ๐š‹๐š˜๐š—๐šŽ
โ˜…๐™ท๐š’๐šœ๐š๐š˜๐š›๐šข ๐š˜๐š ๐š๐šŠ๐š•๐š• ๐š’๐š— ๐š˜๐šž๐š๐šœ๐š๐š›๐šŽ๐š๐šŒ๐š‘๐šŽ๐š ๐š‘๐šŠ๐š—๐š .

๐Ÿ„ผ๐Ÿ„ด๐Ÿ„ฒ๐Ÿ„ท๐Ÿ„ฐ๐Ÿ„ฝ๐Ÿ„ธ๐Ÿ…‚๐Ÿ„ผ :

Outstretched hand เฆ…เฆฌเฆธเงเฆฅเฆพเงŸ เฆ•เง‡เฆ‰ เฆชเงœเง‡ เฆ—เง‡เฆฒเง‡ เฆฌเฆพ

Forearm เฆฌเฆฐเฆพเฆฌเฆฐ force apply เฆนเฆฒเง‡ เฆธเง‡เฆŸเฆพ extended wrist เฆ transmit เฆนเงŸเงท เฆเฆฐ เฆซเฆฒเง‡ Corticocancellous Junction เฆ fracture เฆนเงŸเฅค

๐Ÿ”˜ ๐˜พ๐™ก๐™ž๐™ฃ๐™ž๐™˜๐™–๐™ก ๐™›๐™š๐™–๐™ฉ๐™ช๐™ง๐™š๐™จ:

  • ๐Ÿ”ธ๐˜—๐˜ข๐˜ช๐˜ฏ
  • ๐Ÿ”ธ๐˜š๐˜ธ๐˜ฆ๐˜ญ๐˜ญ๐˜ช๐˜ฏ๐˜จ
  • ๐Ÿ”ธ๐˜‹๐˜ช๐˜ฏ๐˜ฏ๐˜ฆ๐˜ณ ๐˜ง๐˜ฐ๐˜ณ๐˜ฌ ๐˜ฅ๐˜ฆ๐˜ง๐˜ฐ๐˜ณ๐˜ฎ๐˜ช๐˜ต๐˜บ ๐˜ช๐˜ง ๐˜ง๐˜ณ๐˜ข๐˜ค๐˜ต๐˜ถ๐˜ณ๐˜ฆ๐˜ฅ ๐˜ช๐˜ฏ ๐˜ฅ๐˜ช๐˜ด๐˜ต๐˜ข๐˜ญ ๐Ÿ”ธ๐˜ฅ๐˜ฐ๐˜ณ๐˜ด๐˜ข๐˜ญ ๐˜ฑ๐˜ข๐˜ณ๐˜ต .
  • ๐Ÿ”ธ๐˜‹๐˜ช๐˜ด๐˜ฑ๐˜ญ๐˜ข๐˜ค๐˜ฆ๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต ๐˜ฎ๐˜ข๐˜บ ๐˜ฃ๐˜ฆ ๐˜ฑ๐˜ข๐˜ญ๐˜ฑ๐˜ข๐˜ฃ๐˜ญ๐˜ฆ

๐Ÿ”˜ Investigation :

โžก๏ธ X ray wrist both A/P & lateral view including distal radius & ulna ( transverse fracture of the radius at cortico cancellous Junction)
โžก๏ธ CT scan if X ray can’t confirm the fracture.

๐Ÿ”˜ Treatment :

เฆฏเฆฆเฆฟ Displaced เฆจเฆพ เฆนเงŸเฆƒ-

  • Dorsal splint/ cast / short arm posterior cast for 4 to 6 week.
  • 6 week เฆชเฆฐ cast เฆ–เงเฆฒเง‡ เฆฆเง‡เงŸเฆพ เฆนเงŸ เฆเฆฌเฆ‚ Joint เฆนเฆพเฆฒเฆ•เฆพ movement เฆ•เฆฐเฆคเง‡ เฆฌเฆฒเฆพ เฆนเงŸ เฆฏเฆพเฆคเง‡ Joint stiff เฆจเฆพ เฆนเงŸเง‡ เฆฏเฆพเงŸเฅค
    เฆฏเฆฆเฆฟ Displaced เฆนเงŸเฆƒ-
  • Close reduction under general anesthesia or regional anesthesia.
  • Traction & counter traction followed by colles’ plaster for 6 week.

Precaution: Close monitoring if there is any Cyanosis or not.

  • 6 week เฆชเฆฐ Plaster เฆ–เงเฆฒเง‡ physiotherapy เฆฆเฆฟเฆคเง‡ เฆนเฆฌเง‡เฅค

๐ŸŸฉComplications:

๐Ÿ”ฐ Early:
โ–ช๏ธInjury to radial artery
โ–ช๏ธCarpal tunnel syndrome
โ–ช๏ธReflex sympathetic dystrophy
โ–ช๏ธShoulder hand syndrome
โ–ช๏ธRedisplacement
๐Ÿ”ฐ Late:
โ–ช๏ธMalunion
โ–ช๏ธDelayed union or non- union
โ–ช๏ธStiffness
โ–ช๏ธSecondary osteoarthritis

  • ๐˜ฟ/๐˜ฟ of ๐˜พ๐™ค๐™ก๐™ก๐™š๐™จ’ ๐™›๐™ง๐™–๐™˜๐™ฉ๐™ช๐™ง๐™š:

๐Ÿ”น๐•Š๐•ž๐•š๐•ฅ๐•™’๐•ค ๐•—๐•ฃ๐•’๐•”๐•ฅ๐•ฆ๐•ฃ๐•–
๐Ÿ”น๐”น๐•’๐•ฃ๐•ฅ๐• ๐•Ÿ’๐•ค ๐•—๐•ฃ๐•’๐•”๐•ฅ๐•ฆ๐•ฃ๐•–
๐Ÿ”น๐”ฝ๐•ฃ๐•’๐•”๐•ฅ๐•ฆ๐•ฃ๐•– ๐•ฃ๐•’๐••๐•š๐•’๐• ๐•ค๐•ฅ๐•ช๐•๐• ๐•š๐•• ( โ„‚๐•™๐•’๐•ฆ๐•—๐•—๐•ฆ๐•–๐•ฃ’ ๐•ค ๐•—๐•ฃ๐•’๐•”๐•ฅ๐•ฆ๐•ฃ๐•–)

Edited By : Nahid Hassan.

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colles'

Israt purobi

Osteoporotic

Outstretched hand

Treatment

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