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.

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."

The Radius

 

The radius is commonly fractured at the wrist. Because of the close connections with the ulna, breaks often happen together - at the wrist, the radius is the bone that is important, and is used to categorise the break. 

Colles Fracture

Radius within 2.5cm of the wrist. Distal fragment angulated to point dorsally.
Analgesia, POP, elevation
Discharge undisplaced

Complications: stiffness, malunion, reflex sympathetic dystrophy (Sudeck's atrophy) - refer for physiotheraphy, carpal tunnel syndrome, extensor pollicis longus rupture

 

Smith's Fracture

Unstable distal radius fracture (or reverse Colles' fracture)
The distal fragment is impacted, tilted anteriorly.
From a fall onto a flexed wrist.
Analgesia, POP, orthopaedics

Barton's Fracture

Intra-articular fracture involving the volar portion of the distal radius. The resultant fragment slips anteriorly, so the fracture is unstable.
POP and refer 

http://radiopaedia.org/articles/colles-fracture 
http://emergencymedicineireland.com/2012/05/anatomy-for-emergency-medicine-17-colles-fractures/
http://emrems.com/tag/colles/
http://emj.bmj.com/content/29/9/781.2.extract 
http://radiopaedia.org/cases/distal-radial-fracture-colles-fracture-1
http://blog.ercast.org/2011/07/distal-radial-fractures/
http://radiopaedia.org/cases/colles-fracture-1
http://radiopaedia.org/cases/colles-fracture-6
http://www.ajemjournal.com/article/S0735-6757%2809%2900492-6/abstract

Smith's Fracture
http://www.enlightenme.org/learning-zone/when-colles%E2%80%99-not-colles%E2%80%99
http://radiopaedia.org/articles/smith-fracture
http://radiopaedia.org/cases/smith-fracture

Barton's Fracture
http://lifeinthefastlane.com/bone-and-joint-bamboozler-003/