II. Definitions
- Forearm Fracture
- Mid-shaft Fracture of the radius and/or ulna
III. Types: Distal Forearm and Wrist
-
Colles Fracture
- Distal Radius Fracture (often with ulnar styloid Fracture)
- "Dinner fork" deformity (distal fragment angulated dorsally)
-
Smith's Fracture
- Distal Radius Fracture with displacement towards volar aspect
- Opposite of Colles Fracture
IV. Types: Shaft
- Mnemonic: GRUM (from distal radius to proximal ulna)
- GR: Galeazzi - Radius Fracture
- Displacing the distal radius and injuring the Ulnar Nerve
- UM: Ulna - Monteggia Fracture
- Displacing the proximal radius and injuring the Radial Nerve (Wrist Drop)
- GR: Galeazzi - Radius Fracture
-
Galeazzi Fracture
- Fracture of the distal shaft of radius
- Dislocation of Distal radio-ulnar joint (ulna will appear medially displaced at the wrist)
- Risk of Ulnar Nerve injury
-
Monteggia Fracture
- Proximal ulna Fracture of shaft (typically displaced)
- Proximal Radial Head Dislocation
- Risk of Radial Nerve injury
V. Types: Proximal Forearm and Elbow
- Supracondylar Fracture of Humerus (most common in children)
- Radial Head Fracture (most common in adults)
VI. Signs
- Usually shortened and displaced
VII. Complications
- High rate of non-union in adults
- Risk of unstable Fractures even when initially non-displaced and despite external immobilization
- Radial Head Dislocation in proximal ulnar Fracture (Monteggia Fracture)
VIII. Imaging
- Xray should show entire Forearm including wrist and elbow
IX. Indications: Referral
- Orthopedic referral is indicated in most cases
X. Management: Adults
- Displaced Forearm Fractures
- May attempt closed reduction
- Open reduction and Internal Fixation (ORIF)
- Usually indicated
- Length of immobilization is shorter
- Non-displaced Forearm Fractures
- Long Arm Cast with elbow at 90 degrees for 8-12 weeks
XI. Management: Children
- Surgical intervention rarely needed
- Reduction Technique
- Light Anesthesia
- Angulated Fractures
- Traction and Counter traction
- Greenstick Fractures
- Often require breakage of opposite cortex
- Prevents re-angulation in cast
- Displaced Fractures
- Traction and Counter traction
- Slight bayonet apposition is acceptable
- Alignment must be satisfactory
- Immobilization in Long Arm Cast for 7-8 weeks
XII. Management: Follow-up
- Examine at weekly intervals for 3 weeks
- Inspect for re-angulation
- Angulation under 2 weeks
- Correct angulation manually
- Angulation over 2 weeks
- Angulation may be permanent
- Angulation under 2 weeks
Images: Related links to external sites (from Bing)
Related Studies
Concepts | Injury or Poisoning (T037) |
ICD10 | S52 , S52.9 |
SnomedCT | 208292008, 213497006, 65966004 |
English | Fract of forearm, unspecif, Fracture of forearm, part unspecified, Fracture of forearm, unspecified, [X]Fract of forearm, unspecif, [X]Fracture of forearm, unspecified, Unspecified fracture of forearm, forearm fractures of, Fracture;forearm, forearm fractures, forearm fracture, fracture of forearm, fracture forearm, [X]Fracture of forearm, unspecified (disorder), Fracture of forearm (diagnosis), fracture upper limb forearm, Forearm fracture, Fracture of forearm, Fracture of forearm (disorder), Fracture of forearm, NOS, Forearm Fracture, fractured forearm |
Italian | Frattura dell'avambraccio |
Japanese | 前腕骨折, ゼンワンコッセツ |
German | Fraktur des Unterarmes, Teil nicht naeher bezeichnet, Fraktur des Unterarmes, Fraktur des Unterarms |
Czech | Zlomenina předloktí |
Korean | 아래팔의 골절, 상세불명의 아래팔 부분의 골절 |
Hungarian | Alkartörés |
Spanish | fractura del antebrazo, fractura del antebrazo (trastorno), [X]fractura del antebrazo, no especificada, [X]fractura del antebrazo, no especificada (trastorno), fractura de antebrazo (trastorno), fractura de antebrazo, Fractura de antebrazo |
Dutch | Fractuur van onderarm, deel niet gespecificeerd, onderarmbreuk, Fractuur van elleboog en onderarm |
Portuguese | Fractura do antebraço |
French | Fracture de l'avant bras |