| Table 4. Reasons to consider referral for Colles' fractures |
| Greater degrees of radial shortening, dorsal angulation, radial inclination or radial fragment
displacement, suggesting potential instability
> 2 mm step deformity of the radius in the radiocarpal joint Complex joint involvement Comminution of the radius extends from the dorsal surface volarly beyond the midaxial line of the radius on the lateral view, or is more severe Fracture fails to maintain position or is stable after reduction only in an extreme casting position Ulnar styloid fractured through its base rather than more distally High kinetic energy mechanism of injury Development of pain not relieved by recasting |