Forearm fractures

Forearm Fractures

Dr. Wahby Ghalib CABMS, FJMC, MRCS

The radius rotates around the ulna  pronation 90° supination 90°

Both Bones #

Fall on the hand  #s at different levelsDirect trauma  same level

Rx

< 14 yr

CR + above elbow castIf irreducible or unstable  ORIF

Cast

Upper 1/3 : in supination Middle 1/3 : neutral Lower 1/3 : pronation

> 14 yr

ORIF because unstable

Cx


Early : compartment syndromeLate : malunion synostosis  affect pronation-supination

# of the ulna alone

uncommon Night - stick # May be missed Nonunion is common

Monteggia fracture dislocation

# of proximal 1/3 ulna + dislocation of radial head

Types (Bado)

I : Anterior : commonest II : Posterior III : Lateral IV : With # of proximal radius

Mechanism

Fall on outstretched hand Direct



Rx

Child

CR + cast

Adult

ORIF of ulnar # CR of radial head immobilization in supination

Galeazzi fracture dislocation

# of distal 1/3 radius + dislocation or subluxation of DRUJ > common than Monteggia

Mechanism

Fall on hand

Unstable DRUJ

Piano key sign Rotatable wrist


Rx

Child

CR + cast

Adult

ORIF of radius # + CR of DRUJ immobilize in supination