Forearm fractures March 2018 | by EMauthor Isolated fractures of radius or ulna •If undisplaced or not angulated , treat with above elbow back slab with fracture clinic follow up •Displaced and/or angulated, refer to orthopaedics •Beware of fracture dislocation of forearm bones oUlnar shaft fracture with dislocation of radial head – Monteggia fracture-dislocation oIn the normal elbow x-ray, a line through the axis of the radius will cut through the central capitulum, in Monteggia fracture this line will pass either anterior, posterior or lateral to the capitulum •Radial shaft fracture with dislocation of inferior radio-ulnar joint – Galeazzi fracture-dislocation oThis is identified by looking at the space between the lower ends of the radius and ulna which will be widened •Both are unstable fractures •Always examine the wrist and elbow clinically and radiologically •Always refer these fractures to orthopaedics Fractures of both radius & ulna in children •If undisplaced and not angulated, you can treat with above elbow back slab in the neutral position (mid pronation), with sling, analgesia and fracture clinic review •If there is angulation, they often need manipulation, refer to orthopaedics Fractures of both radius & ulna in adults •Often requires open reduction and internal fixation, refer to orthopaedics |
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