Please describe this fracture below, who ever describes this fracture most accurately will win the amazon gift certificate.
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mritchie
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5 Comments
wendyrollerblades · July 17, 2013 at 4:52 pm
Dorsally displaced complete extra-articular metaphyseal fractures of both distal radius and ulnar of the left upper extremity – wendy PGY I
Carl · July 20, 2013 at 10:04 pm
So ya this is a dorsally angulated foreshortened displaced extra articular fracture of both distal radius and ulnar.
Aka Colle’s fracture, type 2, depending on the classification system yo use.
I think it is the left hand as well. sorry andy.
andygrock · July 20, 2013 at 6:42 pm
how in sam heck do you know it’s the Left?
anyway, as left has already been guessed, I’ll go with Right upper extremity, complete transverse fracture of distal radius and ulna, severely displaced in both the ventral and ulna directions (hard to tell -but typically name the displaced based on how the distal end compares to the proximal), extra-articular. looks closed on xray, but that would be easier to see on physical exam. There is also a word to describe how the distal end is moved proximally. I think shortened?
k. that’s all.
wendyrollerblades · July 21, 2013 at 3:58 pm
I wanted to add that there is a 3rd fracture.. the ulnar styloid process. My understanding of a Colles fx is that it can include styloid fx (IE type II like Carl said), but not ulnar metaphysis fracture. so i think we would have to specifically mention the ulnar metaphysis fx in addition to saying colles type II.
Regarding L v R.. my reasoning:
-wrist xrays are usually taken PA, prone position, palm down. Given the “dinner fork” deformity, I didn’t think the xray tech would buck this tradition and have the patient torque their forearm to place the palm face up (and the painful swollen “hump” down on the hard surface).
so.. left. i think.
andygrock · July 20, 2013 at 6:42 pm
how in sam heck do you know it’s the Left?
anyway, as left has already been guessed, I’ll go with Right upper extremity, complete transverse fracture of distal radius and ulna, severely displaced in both the ventral and ulna directions (hard to tell -but typically name the displaced based on how the distal end compares to the proximal), extra-articular. looks closed on xray, but that would be easier to see on physical exam. There is also a word to describe how the distal end is moved proximally. I think shortened?
k. that’s all.