FRACTURE OF
RADIUS AND ULNA
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Distal Radius Fracture
◦ A distal radius fracture is a
common bone fracture of
the radius in the forearm.
Because of its proximity to the
wrist joint , this injury is often
called a (wrist fracture).
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Deformity in the Wrist
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Associated median nerve injury
Thenar muscles paralysed.
This affects opposition of the thumb and
flexion of the index and middle fingers.
Hand of
benediction
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Associated injuries
Colles’ fracture:
Smith’s fracture: (reverse colles’
fracture)
is a fracture of the distal radius in the
forearm with dorsal (posterior)
displacement of the wrist and hand
fracture of the distal radius .
It is caused by a direct blow to the
dorsal forearm or falling onto flexed wrists.
-Less common than colles’ fracture.
Mechanism :
Falling on an outstretched hand
•Mechanism
a fall onto a flexed wrist, OR
direct blow to the back of the wrist
The characteristic appearance is
called: (dinner fork deformity)
The characteristic appearance is
called: (garden spade deformity)
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Radial Head Fractures
Incidence:
◦radial head fractures are among the most
common elbow fractures
◦occur in up to 20% of all elbow injuries
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Mechanism of injury
◦fall on outstretched hand
◦forearm in pronated position
◦axial load created across elbow
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Associated injuries.
◦ 30% have associated soft tissue or skeletal injuries including
- distal Radioulnar joint (DRUJ) injuries
- Interosseous membrane disruption.
- coronoid fractures
- elbow dislocation
- carpal fractures
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Radius and Ulnar Shaft Fractures
• Anatomy:
The ulna acts as an axis around which the
laterally
bowed
radius rotates in supination and pronation.
• Interosseous membrane (IOM) :
- occupies the space between the radius
and ulna and comprised of 5 ligaments.
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Mechanism
◦direct trauma (most common) :
◦ often while protecting one's head
◦indirect trauma :
◦ motor vehicle accidents
◦ falls from height
◦ athletic competition
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Signs and Symptoms
1. gross deformity. (dorsal bowing
of the radius and ulna)
2. pain, swelling
3. loss of forearm and hand function
4. Decreased sensation or inability
to move the limb, which may
indicate nerve damage
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Associated conditions
◦ 1) Elbow injuries
evaluate DRUJ and elbow for :
A- Galeazzi fractures
B- Monteggia fractures
◦ 2)Compartment syndrome
evaluate compartment pressures if concern for compartment
syndrome
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Types of Fractures
◦ Galeazzi fracture
◦ Defined as a fracture of the distal one third of the radius with
dislocation of the distal radioulnar joint (DRUJ).
◦ Monteggia fracture
◦ Defined as a fracture of the ulna (usually proximal one third)
with dislocation of the radial head.
◦ Greenstick fracture
◦ Fracture on one side of the bone, causing a bend on the other
side of the bone.
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Galeazzi fracture
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◦Neurovascular injury
- uncommon except
◦ PIN injury with Monteggia fxs and Henry (volar) approach to
middle and upper third radial diaphysis
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THANK YOU
Abeer Alotaibi
Fatimah Almuhana
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