الفهرس 
1) Chapter (1) : INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Colles’ fracture is one of the most common fracture of distal radius about 2-5
cm proximalto the radio-carpal joint with dorsal (posterior) and lateral
displacement of the distal fragment resulting in characteristic ”dinner fork” like
deformity.
The force transmission of the wrist is about 75-90% through radius &
10-25% through ulna.
Colles’ fracture is commonly caused by falling on outstretched hand or direct
trauma with big force.
Colles’ fracture is common in elderly people and post menopausal women.
Colles’ fracture is more common in outdoor than indoor working people. The
treatment of non displaced colles’ fractures is immobilization with cast for 4 to
6 weeks whereas displaced fractures that are adequately reduced require 6 to 12
weeks of immobilization; while the unstable fractures may require
percutaneous pinning, internal fixation, or external fixation.
Smokers are more likely to have a mal, delayed or non union than nonsmokers;
which leads to persistent pain and lower chance of return to normal
function.
Smoking has also direct effects on the blood cells, the blood vessels, and;
Nicotine causes vasoconstriction of the blood vessels, and inhibits the function
of red blood cells; and other chemicals present in cigarette smoke decreases the
level of oxygen present in the blood; leading to longer healing time and
increased risk of improper healing.
The factors that have negative effects on healing of bone fractures are:
1) Debilitating old age >60 years old.
2) Bone diseases and osteoporosis.
3) Co-morbid and debilitating diseases: as diabetes mellitus, anemia,
malnutrition, peripheral vascular diseases and hypothyroidism.
4) Prescribed medications: as non-steroidal anti-inflammatory drugs,
statins and corticosteroids.
5) Non-prescribed medications: as smoking and alcohol.[59]In this study that aimed to compare between results of healing of colles’
fracture in cigarettes’ smokers and non smokers, conducted on (200) patients
with colles’ fractures that all treated with conservative treatment (closed
reduction and above or below elbow cast according to involvement of ulnar
styloid process or not) under narcotic analgesic; half of them (100 ) patients
were smokers and the other half (100 ) patients were non smokers;
the patients were evaluated for healing by:- (1) clinical examination for
tenderness, deformity, range of movements, and neuro-vascular affection.
(2) Radiological assessment with bipolar antero-posterior and lateral x-ray
views. (3) Functional assessment using modified Mayo score that includes four
categories; which are pain, function, pronation & supination degrees, and hand
grip strength. In smokers there were (84) patients with satisfactory results
[ excellent + good ]; and (16) patients with unsatisfactory results [ fair + poor ]
and (4) patients with complications ( 2 patients with mal union, 1 patient with
nerve affection & 1 patient with wrist stiffness); in comparison that In smokers;
there were (68) patients with satisfactory results [ excellent + good ];and (32)
patients with unsatisfactory results [ fair + poor ] and (10) patients with
complications ( 3 patients with delayed union, 2 patients with mal union,
2 patients with nerve affection & 3 patients with wrist stiffness); with
increment of fair and poor results and decrement of excellent and good results
in smokers’ patients. That means that smoking has a negative effect on healing
of colles’ fracture.