Unterarmfraktur
Forearm fractures are a group of fractures that occur in the forearm following trauma. The radius and ulna are bound together at the proximal and distal radioulnar joints and act as a ring. Like elsewhere in the body, it is difficult to only fracture one bone if there is a bony ring. If the radius or ulna is fractured, it is likely there is another fracture or one of the radioulnar joints has been damaged.
Epidemiology
Forearm fractures are seen in all age-groups although as with most simple trauma, there is a bimodal age and sex distribution with high-trauma injuries in the younger age-group and simple falls in the older age-group.
Clinical presentation
The majority of patients present with a history of trauma to the forearm and pain. They are reluctant to move their wrist or elbow and depending on the severity of the injury there may be a deformity.
An x-ray of the forearm will determine the type of injury that has occurred. In most cases, there will either be a paired radial and ulnar fracture or an isolated radial fracture and dislocation of the distal or proximal radioulnar joint.
Radiographic features
Forearm fractures are readily diagnosed on plain radiographs, and further imaging is rarely required.
Plain radiograph
AP and lateral X-rays of the forearm are performed.
A radial or ulnar fracture will be visible on at least one view. It is important to determine what type of fracture it is, e.g. transverse, oblique, comminuted.
If there is only one fracture, it is important to look for a second fracture, or see if there is damage to the proximal or distal radioulnar joint:
- Monteggia fracture-dislocation: ulna fracture and dislocation of the radial head at the elbow
- Galeazzi fracture-dislocation: radial fracture and dislocation of the distal ulna from the carpus
Treatment and prognosis
Treatment depends on the degree of displacement and/or comminution. These fractures are often accompanied by a significant amount of displacement and require reduction. If there is associated radial head or distal ulnar dislocation, manipulation with reduction of the fracture and dislocation is required.
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- fracture
- terminology
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- diaphyseal fracture
- metaphyseal fracture
- physeal fracture
- epiphyseal fracture
- fracture types
- avulsion fracture
- articular surface injuries
- complete fracture
- incomplete fracture
- infraction
- compound fracture
- pathological fracture
- stress fracture
- fracture displacement
- fracture translation
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- skull fractures
- base of skull fractures
- skull vault fractures
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- alveolar process fractures
- frontal sinus fracture
- isolated zygomatic arch fractures
- mandibular fracture
- nasal bone fracture
- orbital blow-out fracture
- paranasal sinus fractures
- complex fractures
- dental fractures
- fractures involving a single facial buttress
- spinal fractures
- classification (AO Spine classification systems)
- cervical spine fracture classification systems
- AO classification of upper cervical injuries
- AO classification of subaxial injuries
- Anderson and D'Alonzo classification (odontoid fracture)
- Levine and Edwards classification (hangman fracture)
- Roy-Camille classification (odontoid process fracture )
- Allen and Ferguson classification (subaxial spine injuries)
- subaxial cervical spine injury classification (SLIC)
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
- cervical spine fracture classification systems
- spinal fractures by region
- spinal fracture types
- classification (AO Spine classification systems)
- rib fractures
- sternal fractures
- upper limb fractures
- classification
- Rockwood classification (acromioclavicular joint injury)
- AO classification (clavicle fracture)
- Neer classification (clavicle fracture)
- Neer classification (proximal humeral fracture)
- AO classification (proximal humeral fracture)
- AO/OTA classification of distal humeral fractures
- Milch classification (lateral humeral condyle fracture)
- Weiss classification (lateral humeral condyle fracture)
- Bado classification of Monteggia fracture-dislocations (radius-ulna)
- Mason classification (radial head fracture)
- Frykman classification (distal radial fracture)
- Mayo classification (scaphoid fracture)
- Hintermann classification (gamekeeper's thumb)
- Eaton classification (volar plate avulsion injury)
- Keifhaber-Stern classification (volar plate avulsion injury)
- upper limb fractures by region
- shoulder
- clavicular fracture
- scapular fracture
- acromion fracture
- coracoid process fracture
- glenoid fracture
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- proximal humeral fracture
- humeral neck fracture
- arm
- elbow
- forearm
- wrist
- carpal bones
- scaphoid fracture
- lunate fracture
- capitate fracture
- triquetral fracture
- pisiform fracture
- hamate fracture
- trapezoid fracture
- trapezium fracture
- hand
- shoulder
- classification
- lower limb fractures
- classification by region
- pelvis
- hip
- Pipkin classification (femoral head fracture)
- Garden classification (hip fracture)
- American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture)
- Cooke and Newman classification (periprosthetic hip fracture)
- Johansson classification (periprosthetic hip fracture)
- Vancouver classification (periprosthetic hip fracture)
- femoral
- knee
- Schatzker classification (tibial plateau fracture)
- Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture)
- tibia/fibula
- Watson-Jones classification (tibial tuberosity avulsion fracture)
- ankle
- foot
- Berndt and Harty classification (osteochondral lesions of the talus)
- Sanders CT classification (calcaneal fracture)
- Hawkins classification (talar neck fracture)
- Myerson classification (Lisfranc injury)
- Nunley-Vertullo classification (Lisfranc injury)
- pelvis and lower limb fractures by region
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- classification by region
- terminology