In order to analyze the pressure on the carpal tunnel in the acute phase after Colles' fractures 13 patients were studied. The initial pressure and the variation after injection of a local anesthetic into the fracture hematoma, as well as the effects of increased volar flexion of the wrist, were measured using a wick catheter technique. Comparisons were made with a control group of ten healthy volunteers. The pressure was significantly higher in the fracture group than in the control group, and it increased significantly after injection of a local anesthetic into the fracture hematoma. A correlation was found between high increases after local anesthetic injection and high initial pressure. The pressure increased linearly with volar flexion of the wrist. There was a correlation between high increases due to volar flexion of the wrist and high initial pressure. The trauma itself causes increased carpal tunnel pressure due to edema and bleeding. Injection of a local anesthetic solution increases the fluid content of the carpal tunnel and raises the pressure. Volar flexion of the wrist decreases the space in the carpal tunnel, which also increases the pressure.

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In a prospective series of 75 patients the results of early external fixation of comminuted intraarticular Colles' fractures were studied. Comparison was made to a control group of 32 patients treated with plaster cast fixation. The groups were equal with regard to age, sex and fracture type. The treatment consisted of reduction in general anaesthesia or arm block followed by the application of a small external fixation device. The fixation lasted for five weeks after which the patients were allowed free exercises. For evaluation at the one year follow up the following variables were used: Radiographic appearance. Healing in of the styloid process of the ulna. Subjective evaluation according to the Lidström score. Objective evaluation including range of motion and grip strength. In all follow up variables the treatment group was significantly better than the control group. The prognosis of conservatively treated comminuted intraarticular Colles' fractures is poor. The results of after external fixation are, however, very encouraging and the method can be recommended.