Forearm fractures

From WikiLectures

  • They arise by mechanism:
    • direct – only one bone may be injured;
    • indirect – always both bones are injured or Monteggi and Galeazzi.
  • Dislocation of the radius according to the amount of fracture:
    • in the upper third - traction of the supinator and biceps;
    • in the lower third - pronator traction.
Colles fracture

Classification[edit | edit source]

  1. Fractures of the proximal radius – head fractures (Mason I–III), neck fractures;
  2. Fractures of the proximal ulna – fractures of the olecranon (Colton I–III), fracture of the proc. coronoideus (st. 1-3);
  3. fractures of the diaphysis of the radius and ulna:
  4. fractures of the distal radius:
    • extraarticular:
    • partially intra-articular:
      • sagittal dislocation;
      • dorsal dislocation (Barton I);
      • ventral edge avulsion (Barton II);
    • intra-articular comminuted (Melon).

Complications[edit | edit source]

Treatment[edit | edit source]

Conservative[edit | edit source]

  • Possible for non-displaced fractures of both bones (circular cast fixation from mid-arm to metacarpal heads, elbow in 90° flexion, forearm in supination for fractures in the upper half, in pronation in the lower half, for 12-16 weeks).
  • For isolated fractures of one forearm, cast fixation for 8 weeks - for non-isolated fractures of the ulna and upper two-thirds of the radius (in supination), fractures of the lower third of the radius indicated for operative treatment.
  • For fractures of the distal radius (Colles, Smith), plaster fixation for 6 weeks - from the metacarpal heads below the elbow, with the wrist in ulnar duction and flexion (Colles) or extension (Smith).

Surgical[edit | edit source]

  • Recommended for isolated fractures (the second, unbroken bone then acts as a spacer and leads to the formation of a subluxation); Galeazzi and Monteggi fractures are also indicated, as are all dislocated and open fractures.
  • Autocompression splints and intra-articular fixation with spikes are mainly used, external fixation in open and splinter fractures, splints, K-wires, screws, external fixation in distal forearm fractures.


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