Forearm fracture: Difference between revisions

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==[[Radia Ulna Fracture]]==
==[[Radia Ulna Fracture]]==
===Background===
*Requires great amount of force (vehicular trauma, falls from height, direct blow)
*Neurovascular complications are unusual
===Imaging===
*Always consider wrist and elbow films
*Assess for angulation
**AP view: radial styloid and radial tuberosity normally point in opposite directions
**Lateral view: ulnar styloid and coronoid process normally point in opposite directions
===Management===
*Rule-out compartment syndrome
*ORIF


==[[Isolated Radius Fracture (Proximal)]]==
==[[Isolated Radius Fracture (Proximal)]]==

Revision as of 23:34, 7 March 2012

Background

  • Solitary fractures of the forearm are uncommon
    • Fractures usually occur at two or more sites or also involve a ligamentous injury

Radia Ulna Fracture

Isolated Radius Fracture (Proximal)

Background

  • Rare
  • When occur, most are displaced
  • Compartment syndrome is rare

Management

  • Nondisplaced: cast immobilization
  • Displaced: Internal fixation

Isolated Ulna (Nightstick)

Background

  • Most often due to direct trauma

Management

  • Stable: short arm cast
  • Unstable: ORIF
    • >50% displacement
    • >10% angulation
    • Involvement of proximal 1/3

Monteggia Fracture-Dislocation

Background

  • Ulna fx (proximal third) + radial head dislocation
  • Easy to overlook the radial head dislocation (will result in worse outcome)

Clinical Features

  • Pain/swelling at elbow
  • Radial head may be palpable in an anterolatera or posterolateral location

Management

  • Consult ortho in the ED; likely requires ORIF

Galeazzi Fracture-Dislocation

Background

  • Radius fx (distal third) + distal radioulnar dislocation
  • Caused by FOOSH or direct blow

Clinical Features

  • Localized tenderness/swelling over distal radius/wrist

Diagnosis

  • PA: May only show slightly increased distal radioulnar joint space
  • Lateral: Ulna is displaced dorsally

Management

  • Consult ortho in the ED; likely requires ORIF

See Also

Fracture (Main)

Source

  • Tintinalli