Fractures of the forearm

They are formed by the mechanism:
- direct – only one bone can be injured;
- indirect – always injured both bones or Monteggi and Galeazzi.
Dislocation of the radius according to the height of the fracture:
- in the upper third – the pull of the supinator and biceps;
- in the lower third – pronator pull.

Classification[edit | edit source]

$Collesfracture.jpg$

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. coronoid (st. 1–3);
fractures of the diaphysis of the radius and ulna:
fractures of the distal radius:
- extra-articular:
  - without dislocation;
  - with extension dislocation ( Colles fracture );
  - with flexion dislocation ( Smith's fracture );
- partially intra-articular:
  - sagittal break-off;
  - dorsal break-off (Barton I);
  - break-off of ventral edge (Barton II);
- intra-articular comminutive (Melon).

Possibly for non-dislocated 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, pronation in the lower half, for 12-16 weeks).
For isolated fractures of one forearm bone, plaster fixation is required for 8 weeks - for non-dislocated fractures of the ulna and the upper two thirds of the radius (in supination), fractures of the lower third of the radius are indicated for surgical treatment.
For fractures of the distal radius (Colles, Smith), plaster fixation for 6 weeks - from the heads of the metacarpals to the elbow, with the wrist in ulnar adduction and flexion (Colles) or extension (Smith).

Recommended for isolated fractures (the second, unbroken bone then acts as a spacer and leads to the creation of a joint), Galeazzi and Monteggi fractures are also indicated, as well as all displaced and open fractures.
Self-compression splints and intramedullary nail fixation are mainly used, for open and comminuted fractures external fixation, for distal forearm fractures splints, K-wires, screws, external fixation.

PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 2010]. <http://langenbeck.webs.com>.