There is some evidence that immobilization with the wrist in dorsiflexion as opposed to palmarflexion results in less redisplacement and better functional status. Significant angulation and deformity may require an open reduction and internal fixation or external fixation. The volar forearm splint is best for temporary immobilization of forearm, wrist and hand fractures, including Colles fracture. There are several established instability criteria:
dorsal tilt >20°,
comminuted fracture,
abruption of the ulnar styloid process,
intraarticular displacement >1mm,
loss of radial height >2mm. A higher amount of instability criteria increases the likelihood of operative treatment. Treatment modalities differ in the elderly.Repeat Xrays are recommended at one, two, and six weeks to verify proper healing. Prognosis
Recovery time depends on the degree of bone displacement, the number of bone fragments, whether or not the break is "intra-articular" (involves the wrist joint), as well as the persons age, gender, and medical history, and may range from two months to a year or more for complete recovery. Epidemiology
Colles fractures occur in all age groups, although certain patterns follow an age distribution. In the elderly, because of the weaker cortex, the fracture is more often extra-articular. Younger individuals tend to require a higher energy force to cause the fracture and tend to have more complex intra-articular fractures. In children with open epiphyses, an equivalent fracture is the "epiphyseal slip", as can be seen in other joints, such as a slipped capital femoral epiphysis in the hip. This is a Salter I or II fracture with the deforming forces directed through the weaker epiphyseal plate.
Primary cutaneous histoplasmosis is a rare skin condition, reported on the penis, characterized by a chancre-type lesion with regional adenopathy. : 316

See also
Histoplasmosis


== References ==