Radius and Ulna Shaft Fractures (Forearm Fractures)

Aetiology

  • Common fracture of the forearm caused by direct or indirect trauma

Pathophysiology

  • Radius and ulna are connected by the proximal and distal radioulnar joints - form a ring
    • Usually if there is a fracture of one bone, there is an injury of the other
  • Fracture patterns:
    • Monteggia: fracture of proximal third of the ulna with dislocation of the proximal head of the radius
    • Galeazzi: fracture of the distal third of the radius with dislocation of the distal radioulnar joint
    • Nightstick fracture: isolated fracture of the ulna shaft
Galeazzi
Monteggia
Nightstick
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Clinical presentation

Symptoms

  • Pain and swelling
  • Loss of forearm and hand function

Signs

  • Gross deformity
  • Neurovascular exam
    • Radial and ulnar pulses
    • Median, radian and ulnar nerve function

Investigations

  • X-ray - AP and lateral

Management

  • Conservative - cast
  • Operative - ORIF