Incidence of Early Complications of Close Reduction & Manipulation of Colles’ Fracture, Our Experience.

Abstract

Objectives: The objective of our study was to determine the frequency rate of early complications of the closed treatment of Colles’ fracture and assess the common factors responsible for these complications.

Methods: Our study was a descriptive prospective study. The study was conducted in Jinnah Postgraduate Medical Centre Karachi Pakistan, from June 2018 to May 2019.We included 150 patients of Colles’ fracture with an age range between 40 to 70 years. One hundred fifty patients of Colles’ fracture were managed by close manipulation under local hematoma block and intravenous sedation and below elbow dorsoradial slab was applied and after reduction again X-rays were taken. Patients were sent home with the advice that if they develop swelling of finger or change in color or increase in pain, numbness in hand they should report immediately to the orthopedic department for management. They were called weekly for the first two weeks then after two weeks for a total period of six weeks. The complete POP cast was applied after one week and Re - manipulation was done if required during follow-up visits.

Results: Out of 150 cases reduced by close manipulations under local hematoma block, thirty-six (24%) patients after one week of follow up had loss of reduction and these patients were given trial of re-manipulation. Fifteen (10%) patients developed reflex sympathetic dystrophy, aggressive Physiotherapy and sympathetic blockers and analgesia resolved this problem in all patients. Five (3.3%) patients developed acute carpal tunnel syndrome after one week and managed with an immediate change in the position of the wrist and active physiotherapy. Ten (6.66%) patients developed plaster sore, managed by debridement, and extra padding over the pressure area. One (0.6%) patient developed impending compartment syndrome of forearm, on the 3rd day and was managed by loosening of constricting bandage and elevation off hand.

Conclusion: To evaluate the factors leading to an early complication during the closed treatment of Colles’ fracture. Prompt recognition of complications and immediate intervention can minimize the functional loss, diminishes disability and improve all outcomes of the of injured limb.