Forearm fracture
Revision as of 23:32, 7 March 2012 by Rossdonaldson1 (talk | contribs)
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