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Forearm Fractures

Forearm Fractures. Dr. Wahby Ghalib CABMS, FJMC, MRCS. The radius rotates around the ulna  pronation 90 ° supination 90°. Both Bones #. Fall on the hand  #s at different levels Direct trauma  same level. Rx. < 14 yr. CR + above elbow cast

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Forearm Fractures

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  1. Forearm Fractures Dr. Wahby Ghalib CABMS, FJMC, MRCS

  2. The radius rotates around the ulna  pronation 90° supination 90° Wahby Ghalib

  3. Both Bones # • Fall on the hand  #s at different levels • Direct trauma  same level Wahby Ghalib

  4. Wahby Ghalib

  5. Rx Wahby Ghalib

  6. < 14 yr • CR + above elbow cast • If irreducible or unstable  ORIF Wahby Ghalib

  7. Cast • Upper 1/3 : in supination • Middle 1/3 : neutral • Lower 1/3 : pronation Wahby Ghalib

  8. Wahby Ghalib

  9. > 14 yr • ORIF because unstable Wahby Ghalib

  10. Wahby Ghalib

  11. Cx • Early : compartment syndrome • Late : malunion synostosis  affect pronation-supination Wahby Ghalib

  12. Wahby Ghalib

  13. # of the ulna alone • uncommon • Night - stick # • May be missed • Nonunion is common Wahby Ghalib

  14. Monteggia fracture dislocation • # of proximal 1/3 ulna + dislocation of radial head Wahby Ghalib

  15. Wahby Ghalib

  16. Wahby Ghalib

  17. Types (Bado) • I : Anterior : commonest • II : Posterior • III : Lateral • IV : With # of proximal radius Wahby Ghalib

  18. Wahby Ghalib

  19. Mechanism • Fall on outstretched hand • Direct Wahby Ghalib

  20. Rx Wahby Ghalib

  21. Child • CR + cast Wahby Ghalib

  22. Adult • ORIF of ulnar # CR of radial head immobilization in supination Wahby Ghalib

  23. Galeazzi fracture dislocation • # of distal 1/3 radius + dislocation or subluxation of DRUJ • > common than Monteggia Wahby Ghalib

  24. Wahby Ghalib

  25. Mechanism • Fall on hand Wahby Ghalib

  26. Unstable DRUJ • Piano key sign • Rotatable wrist Wahby Ghalib

  27. Rx Wahby Ghalib

  28. Child • CR + cast Wahby Ghalib

  29. Adult • ORIF of radius # + CR of DRUJ immobilize in supination Wahby Ghalib

  30. Wahby Ghalib

  31. thanks Wahby Ghalib

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