Forearm Fractures

Forearm Fractures

• (Considered as a joint)
• Management:
  • Undisplaced:
    • Possible conservative - cast & follow up
  • Displaced:
    • Anatomical Open reduction and internal fixation by Plating and screws( best fixation)
    • Early motion - Prevents stiffness

Forearm fractures - Complications

• Compartment Syndrome
• Neurovascular injury
• Infection in open # or postop
• Mal-union (if treated conservatively) * loss of supination/pronation
• Nonunion
• Posttraumatic radioulnar synostosis (3- 9% )

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Galeazzi Fracture/ Dislocation

• Fracture of the radius with dislocation of the distal radio-ulnar joint

• “Fracture of necessity”

  • Necessitates surgery

• Fracture of the radius with dislocation of the distal radio-ulnar joint

• “Fracture of necessity”:

  • Necessitates surgery
    • Plating of radius
    • Reduction of distal radio-ulnar joint (+/- Fixation)

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Monteggia Fracture/Dislocation

• Fracture of the proximal third of the ulna with dislocation of the head of the radius
• Dislocated head of radius missed if two joints are not included on the x-ray
• Fracture of the proximal third of the ulna with dislocation of the head of the radius
• “Fracture of necessity”. Treated by:
  • Open reduction and internal fixation of ulna
  • Closed reduction of head of radius
  • +/- fixation

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Colle’s Fracture

• Extra-articular fracture of the distal radius with dorsal and radial displacement of the wrist “Dinner fork” deformity
• Seen in elderly with osteoporosis
• Caused by falling on the outstretched hand

Treatment

• Undisplaced : Cast alone
• Displaced: (Sedation/ UGA / ULA), closed reduction, casting Wrist immobilized in flexion & ulnar deviation

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Intra-articular Distal Radius Fracture

• treated by anatomical open reduction, internal fixation and early mobilization