Tuesday 8 April 2014

Forearm Fractures

It's difficult to separate the radius from the ulnar as you progress up the forearm but isolated fractures can occur. Forearm fractures frequently seen in school aged children after a fall.  Adult fractures may be markedly displaced with little or no bony contact between the fragments. ORIF needed

Isolated ulnar fracture
Rare but can happen if the arm is in a defensive position, as in martial arts. POP. If displaced or angulated, for ORIF.

Isolated radial fracture
Very rare

Monteggia Fracture
    

Ulnar fracture and radial dislocation. You need to look carefully at the radiocapitella line. If it does not transect the middle of the capitlellum, there is a radial head dislocation. Occurs by forced pronation of the outstretched forarm. Urgent ORIF needed.


The Hume fracture is related - anterior dislocation of the radial head + olecranon fracture.

Galeazzi - radial fracture, dislocation at distal radioulnar joint. This occurs in teenagers and is very rare.

Galeazzi-v-Monteggia-XRays
http://www.pemcincinnati.com/blog/fracture-fridays-monteggiazzi/
Remember by:
" MUGR (Mugger): Monteggia Fracture = Ulnar fracture with radial head dislocation; Galeazzi Fracture = Radius fracture with DRUJ dislocation."



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