Forearm fractures
From WikiLectures
- They arise by mechanism:
- 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.
Classification[edit | edit source]
- Fractures of the proximal radius – head fractures (Mason I–III), neck fractures;
- Fractures of the proximal ulna – fractures of the olecranon (Colton I–III), fracture of the proc. coronoideus (st. 1-3);
- fractures of the diaphysis of the radius and ulna:
- fractures of the distal radius:
- extraarticular:
- no dislocation;
- with extensional dislocation (Colles fracture);
- with flexion dislocation (Smith's fracture);
- partially intra-articular:
- sagittal dislocation;
- dorsal dislocation (Barton I);
- ventral edge avulsion (Barton II);
- intra-articular comminuted (Melon).
- extraarticular:
Complications[edit | edit source]
- Pseudoarthrosis;
- compartment syndrome;
- Volkmann's ischemic contracture;
- synostosis between radius and ulna.
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.
Links[edit | edit source]
Related articles[edit | edit source]
Zdroj[edit | edit source]
- PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 2022-17-12]. <http://langenbeck.webs.com>.