Dr R Shadi NgobeniTrauma ConsultantSTUDENTS LECTURE

FOREARM INJURIES

• Monteggia Fracture• Proximal Radius Fracture• Radius Ulna Fracture• Ulna Fracture (Nightstick)• Distal radius fracture and distal radioulna

dislocation(Galeazzi #)• Distal Radius #• Distal radioulna joint injury

MONTEGGIA FRACTURE

• Proximal ulna # with proximal radioulna dislocation(Radius head-Anterior)

• Rx =Open reduction internal Fixation• Cx =PIN injury, Redislocation ,Subluxation or

inadequate reduction

MONTEGGIA #

PROXIMAL RADIUS #

• Displaced/ Non displaced• Rx=Non displaced =AE POP Slab- close follow

up =Displaced=ORIF• Complications=Malunion

RADIUS ULNA #”

• Displaced/ Non displaced• Pattern of Fracture=transverse, oblique, spiral

comminuted• Complications=Acute-Compartment Sx -Vascular Injury -Pin injury• Late=Non/mal union, synostosis and

refracture

RADIUS AND ULNA #

NIGHTSTICK #

• Direct blow to ulna distal 1/3• Displaced or undisplaced• Direct = transverse• Associated rotational forces oblique therefore unstable• Rx=undisplaced well moulded cast, displaced

and unstable ORIF

NIGHTSTICK #

GALEAZZI #

• Distal 1/3 radius # with assoc-dislocation of distal radioulna joint/ instability

AP – widening of DRUJLAT-Dislocation of DRUJAssoc ulna styloid #Shortening of Radial height by > 5mm• Rx = ORIF plus supination or CRPP DRUJ• CX=Mal/ Nan union, DRUJ subluxation

GALEAZZI #

COLLE”S #

• Pathological #-Osteoporotic bone• Distal 2-3cm of distal radius• Clinically = Dinner fork deformity• X-R =PA- radial displacement & impaction may have associated ulna styloid =LAT- Dorsal displacement & apex volar displacementCOLLE”S TYPE #- SAME BUT NORMAL BONE

COLLE”S #

SMITH #

BARTON

VOLAR BARTON DORSAL BARTON

RADIUS STYLOID #

• CHAUFFEUR “S #• NB! Rule out scaphoid #• Rx =ORIF• General=Intra/extra articular and displaced/

undisplaced

DISTAL RADIOULNA JOINT INSTABILITY

• TFCC – ulna styloid #• Evaluate- interosseus membrane, radius head • ESSEX LOPRESTI lesion• Rx-CRPOP in supination / CRPP if CRPOP does

not achieve and maintain reduction

DRUJD/I AND CHAUFFEUR #

DRUJI CHAUFFEUR #

TERRY THOMAS

PERILUNATE DISLOCATION

SCAPHOLUNATE DISSOCIATION

THE END

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