1. I NTERACTIVE CASE DISCUSSION CASE2: AT THE FOOTBALL FIELD Paula V. Arquiza

2. CASE2: AT THE FOOTBALL FIELD A 10 yr old boy was playing football in his school, when he was push by another player. He fell with his hands supporting his body. He was brought at the ER 2 Paula Arquiza

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6. 6 occur in younger patients the result of high energy trauma on the volar flexed wrist. Volar comminution and intraarticular extension Smith's fracture Paula Arquiza

7. 7 Barton's fracture shear type fractures of the distal articular surface of the radius with translation of the distal radial fragment and the carpus Paula Arquiza

8. 8 Die-punch fracture a depression fracture of the lunate fossa of the distal radius. the result of a transverse load through the lunate. Paula Arquiza

9. 9 PATIENT’S X-RAYNormal x-ray Paula Arquiza

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11. C OLLES ’ FRACTURE a wrist fracture involving a break of the end of the radius bone of the forearm ("distal radius fracture") "dinner (or silver) fork deformity" 11 Paula Arquiza

12. SYPMTOMS Arm or wrist pain Bruising Swelling Tenderness Severe pain with movement Trouble moving wrist or arm Wrist appears out of line 12 Paula Arquiza

13. sufficiently strong force on the hand can break the wrist-> The wrist can be broken from a sudden force pushing the hand backwards. A strong force pushing the hand into the forearm can also cause a Colles fracture, which often involves a break of the radius bone near its end. Falling with the wrist hyperextended, with pressure on the distal radius and ulna. 13 What caused it? pull of the forearm muscles can pull the larger end over the smaller like a sleeve, and the bone can shorten like a collapsible drinking cup. Paula Arquiza

14. T YPICAL P LAIN F ILM F INDINGS Dorsal displacement of the distal fragment Comminution at the fracture site Radial shortening Dorsal tilt Radial angulation of the wrist 14 Paula Arquiza

15. JIC

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19. http://www.radiologyassistant.nl/en/476a23436683b 19 http://emedicine.medscape.com/article/398406-imaging http://www.eatonhand.com/hw/hw020.htm http://www.enotes.com/topic/Colles'_fracture http://www.orthosports.com.au/Content_Common/pg-colles.seo 19 Paula Arquiza