Fracture of Radius Ulna and Humerus Elizabeth Travis

Fracture of Radius, Ulna, and Humerus Elizabeth Travis Michael Snyder AH 322 10 -22 -03

Causes of Radius and Ulna Fractures Ø Falling on outstretched arm Ø Direct blow Ø Mountain biking Ø Skateboarding Ø Trauma Ø Automobile accidents Ø Child abuse

Types of Fractures Ø Nightstick fracture l Ø Monteggia fracture l Ø Defined as an isolated midshaft ulnar fracture Defined as a fracture of the ulna (usually proximal one third) with dislocation of the radial head. Galeazzi fracture l Defined as a fracture of the distal one third of the radius with dislocation of the distal radioulnar joint (DRUJ).

Types Cont. l It is also known as a reverse Monteggia fracture. Ø Essex-Lopresti fracture l This is defined as a fracture of the radial head and dislocation of DRUJ, with partial or complete disruption of radioulnar interosseous membrane.

Types Cont. Ø Closed or simple fracture l The bone is broken, but the skin is not lacerated. Ø Open or compound fracture l l The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture The bone may or may not be visible in the wound.

Types Cont. Ø Transverse fracture l The fracture is at right angles to the long axis of the bone. Ø Greenstick fracture l Fracture on one side of the bone, causing a bend on the other side of the bone. Ø Comminuted fracture l A fracture that results in three or more bone fragments.

Types Cont.

Signs and Symptoms Ø Most of the time you will know if you have a broken arm Ø Snap or cracking sound Ø Area will be tender and swollen Ø Obvious deformity Ø Decreased sensation or inability to move the limb, which may indicate nerve damage

Treatment Ø External fixation methods l l l plaster and fiberglass cast-braces splints Ø Internal fixation methods l l l metal plates Pins screws

VOLAR ELBOW

Treatment Cont’ Ø Keep your splint or cast clean and dry Ø If possible, apply ice 2 -3 times a day Ø Keep your arm elevated above the heart as much as possible to decrease swelling Ø Take pain medicine as prescribed

Prognosis Ø Earlier treatment usually improves results Ø Fractures in younger children and adolescents tend to heal better Ø Fractures that have multiple breaks, involve a joint, have open wounds, or become infected could have healing complications.

Prognosis Cont’ Ø Older adults have increased chance of losing some ability or movement in the broken arm. Ø Chronic diseases such as osteoporosis and diabetes may slow the healing process.

Prevention Ø Wear appropriate personal safety equipment as protection. Ø Wear car seat belts Ø Use wrist guards for in-line skating and skateboarding Ø Wear appropriate pads for contact sports Ø Prevent and treat osteoporosis

References Ø http: //orthoinfo. aaos. org/fact/thr_report. cfm ? Thread_ID=326&topcategory=Arm Ø Huang, Enoch MD, MPH, Grims, Peter MD “Forearm Fractures” Ø Baniukiewied, Andrew P. MD, Di. Sandro, Daniel MD “Broken Arm”

Questions Ø 1. What is the difference between a closed fracture and an open fracture? Ø 2. What are some external fixation methods? Ø 3. What are some external fixation methods? Ø 4. What is a comminuted fracture? Ø 5. Why do we call a greenstick fracture?