Forearm fracture: Difference between revisions
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**Fractures usually occur at two or more sites or also involve a ligamentous injury | **Fractures usually occur at two or more sites or also involve a ligamentous injury | ||
==Radia Ulna Fracture== | ==[[Radia Ulna Fracture]]== | ||
===Background=== | ===Background=== | ||
*Requires great amount of force (vehicular trauma, falls from height, direct blow) | *Requires great amount of force (vehicular trauma, falls from height, direct blow) | ||
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*ORIF | *ORIF | ||
==Isolated Radius ( | ==[[Isolated Radius Fracture (Proximal)]]== | ||
===Background=== | ===Background=== | ||
*Rare | *Rare | ||
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*Displaced: Internal fixation | *Displaced: Internal fixation | ||
==Isolated Ulna (Nightstick)== | ==[[Isolated Ulna (Nightstick)]]== | ||
===Background=== | ===Background=== | ||
*Most often due to direct trauma | *Most often due to direct trauma | ||
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**Involvement of proximal 1/3 | **Involvement of proximal 1/3 | ||
==Monteggia Fracture-Dislocation== | ==[[Monteggia Fracture-Dislocation]]== | ||
===Background=== | ===Background=== | ||
*Ulna fx (proximal third) + radial head dislocation | *Ulna fx (proximal third) + radial head dislocation | ||
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*Consult ortho in the ED; likely requires ORIF | *Consult ortho in the ED; likely requires ORIF | ||
==Galeazzi Fracture-Dislocation== | ==[[Galeazzi Fracture-Dislocation]]== | ||
===Background=== | ===Background=== | ||
*Radius fx (distal third) + distal radioulnar dislocation | *Radius fx (distal third) + distal radioulnar dislocation | ||
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===Management=== | ===Management=== | ||
*Consult ortho in the ED; likely requires ORIF | *Consult ortho in the ED; likely requires ORIF | ||
==See Also== | |||
[[Fracture (Main)]] | |||
==Source== | ==Source== | ||
Revision as of 23:32, 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
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)
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
Source
- Tintinalli