Distal forearm fractures and dislocations - cox

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Distal forearm fractures
and dislocations
Dr. Ihab Rassem
Lecturer of Radiology
Ain Shams University
Cairo, Egypt
Radiography

PA & Lateral are sufficient in most cases
Radiographic anatomy
Neutral Ulnar variance
Negative
Positive
Ulnar slant of articular surface of radius
Measured on PA view
Palmar inclination angle
Measure on Lateral view
Fracture types
1.
2.
3.
4.
5.
6.
Colles Fracture
Smith Fracture
Barton fracture
Hutchinson fracture
Essex-Lopresti fracture dislocation
Galeazzi fracture dislocation
Colles Fracture





Most frequently encountered injury to the distal
forearm.
Fall on the outstretched hand with forearm
pronated in dorsiflexion.
Age usually above 50y; F>M.
Extraarticular 2-3 cm away from articular surface
of radius.
Associated # of ulnar styloid process
Smith Fracture



Fracture of the distal radius with volar
displacement and angulation of the distal
fragment
Results from a fall on the back of the hand
or a direct blow to the dorsum of the
hand.
Often referred to as a reverse Colles
fracture.
Smith Fracture
Barton Fracture


Fracture of dorsal margin of the distal
radius extending into the radiocarpal
articulation.
Reverse (or volar) Barton fracture: when it
involves the volar aspect of distal radius
Barton Fracture
Reverse Barton
Hutchinson Fracture



Also known as chauffeur's fracture.
Involves the lateral margin of the distal
radius, extending through the radial
styloid process into the radiocarpal
articulation .
Best seen in PA view
Hutchinson Fracture
Essex-Lopresti Fracture-Dislocation
Complex type injury which comprises
1. Comminuted fracture of the radial head
and neck +/- distal extension.
2. Tear of the interosseous membrane.
3. Dislocation in the distal radioulnar joint.
Galeazzi Fracture–Dislocation
This injury type comprises:1.
2.
Fracture of the distal third of the radius,
Dislocation in the distal radioulnar joint.
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