Differential Diagnosis for Hand Pain with History of Colles Fracture
Single Most Likely Diagnosis
- Malunion or Nonunion of Fracture: This is a common complication of Colles fractures, especially if the fracture was not properly reduced or if there was inadequate immobilization. Malunion can lead to altered wrist mechanics and pain, while nonunion can cause persistent pain and instability.
Other Likely Diagnoses
- Osteoarthritis: A history of Colles fracture increases the risk of developing osteoarthritis in the affected wrist, leading to pain, stiffness, and decreased range of motion.
- Tendonitis or Tenosynovitis: Inflammation of the tendons or their surrounding sheaths can occur due to overuse or repetitive strain, especially if the wrist is not properly aligned after a fracture.
- Carpal Tunnel Syndrome: This condition can develop after a Colles fracture, especially if there is swelling or malalignment that compresses the median nerve.
- Wrist Instability: Ligamentous injuries or malunion of the fracture can lead to instability of the wrist, causing pain and limited mobility.
Do Not Miss Diagnoses
- Compartment Syndrome: Although rare, compartment syndrome is a serious condition that can occur after a fracture, characterized by increased pressure within the muscle compartments, leading to nerve and muscle damage.
- Infection: Osteomyelitis or septic arthritis can occur after a fracture, especially if the wound was contaminated or if there was a delay in treatment.
- Nerve Damage: Direct injury to the nerves during the fracture or subsequent surgery can cause persistent pain, numbness, or weakness.
Rare Diagnoses
- Complex Regional Pain Syndrome (CRPS): A rare condition characterized by chronic pain, swelling, and limited mobility, often occurring after a traumatic injury like a fracture.
- Ganglion Cyst: A benign cyst that can develop in the wrist, causing pain and limited mobility, although this is less directly related to the history of Colles fracture.
- Kienbock's Disease: A rare condition characterized by avascular necrosis of the lunate bone, which can cause wrist pain and limited mobility, although this is not typically directly associated with a history of Colles fracture.