Fracture of Radius, Ulna, Fracture of Radius, Ulna, and Humerusand Humerus

Elizabeth TravisElizabeth TravisMichael SnyderMichael Snyder

AH 322AH 32210-22-0310-22-03

Causes of Radius and Ulna Causes of Radius and Ulna FracturesFractures

Falling on outstretched armFalling on outstretched arm Direct blowDirect blow Mountain bikingMountain biking SkateboardingSkateboarding TraumaTrauma Automobile accidentsAutomobile accidents Child abuseChild abuse

Types of FracturesTypes of Fractures

Nightstick fracture Nightstick fracture Defined as an isolated midshaft ulnar fracture Defined as an isolated midshaft ulnar fracture

Monteggia fracture Monteggia fracture Defined as a fracture of the ulna (usually proximal one Defined as a fracture of the ulna (usually proximal one

third) with dislocation of the radial head. third) with dislocation of the radial head.

Galeazzi fracture Galeazzi fracture Defined as a fracture of the distal one third of the Defined as a fracture of the distal one third of the

radius with dislocation of the distal radioulnar joint radius with dislocation of the distal radioulnar joint (DRUJ). (DRUJ).

Types Cont.Types Cont.

It is also known as a reverse Monteggia It is also known as a reverse Monteggia fracture. fracture.

Essex-Lopresti fracture Essex-Lopresti fracture This is defined as a fracture of the radial head This is defined as a fracture of the radial head

and dislocation of DRUJ, with partial or and dislocation of DRUJ, with partial or complete disruption of radioulnar interosseous complete disruption of radioulnar interosseous membrane. membrane.

Types Cont.Types Cont.

Closed or simple fracture Closed or simple fracture The bone is broken, but the skin is not The bone is broken, but the skin is not

lacerated. lacerated. Open or compound fracture Open or compound fracture

The skin may be pierced by the bone or by a The skin may be pierced by the bone or by a blow that breaks the skin at the time of the blow that breaks the skin at the time of the fracture fracture

The bone may or may not be visible in the The bone may or may not be visible in the wound. wound.

Types Cont.Types Cont.

Transverse fracture Transverse fracture The fracture is at right angles to the long axis The fracture is at right angles to the long axis

of the bone. of the bone. Greenstick fracture Greenstick fracture

Fracture on one side of the bone, causing a Fracture on one side of the bone, causing a bend on the other side of the bone. bend on the other side of the bone.

Comminuted fracture Comminuted fracture A fracture that results in three or more bone A fracture that results in three or more bone

fragments. fragments.

Types Cont.Types Cont.

Signs and SymptomsSigns and Symptoms

Most of the time you will know if you have Most of the time you will know if you have a broken arma broken arm

Snap or cracking soundSnap or cracking sound Area will be tender and swollenArea will be tender and swollen Obvious deformityObvious deformity Decreased sensation or inability to move Decreased sensation or inability to move

the limb, which may indicate nerve the limb, which may indicate nerve damage damage

TreatmentTreatment

External fixation methods External fixation methods plaster and fiberglass casts plaster and fiberglass casts cast-braces cast-braces splints splints

Internal fixation methods Internal fixation methods metal plates metal plates PinsPins screwsscrews

VOLARELBOW

Treatment Cont’Treatment Cont’

Keep your splint or cast clean and dryKeep your splint or cast clean and dry If possible, apply ice 2-3 times a dayIf possible, apply ice 2-3 times a day Keep your arm elevated above the heart Keep your arm elevated above the heart

as much as possible to decrease swelling as much as possible to decrease swelling Take pain medicine as prescribed Take pain medicine as prescribed

PrognosisPrognosis

Earlier treatment usually improves results Earlier treatment usually improves results Fractures in younger children and Fractures in younger children and

adolescents tend to heal better adolescents tend to heal better Fractures that have multiple breaks, Fractures that have multiple breaks,

involve a joint, have open wounds, or involve a joint, have open wounds, or become infected could have healing become infected could have healing complications. complications.

Prognosis Cont’Prognosis Cont’

Older adults have increased chance of Older adults have increased chance of losing some ability or movement in the losing some ability or movement in the broken arm. broken arm.

Chronic diseases such as osteoporosis Chronic diseases such as osteoporosis and diabetes may slow the healing and diabetes may slow the healing process. process.

PreventionPrevention

Wear appropriate personal safety Wear appropriate personal safety equipment as protection. equipment as protection.

Wear car seat belts Wear car seat belts Use wrist guards for in-line skating and Use wrist guards for in-line skating and

skateboarding skateboarding Wear appropriate pads for contact sports Wear appropriate pads for contact sports Prevent and treat osteoporosis Prevent and treat osteoporosis

ReferencesReferences

http://orthoinfo.aaos.org/fact/thr_report.cfmhttp://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=326&topcategory=Arm?Thread_ID=326&topcategory=Arm

Huang, Enoch MD, MPH, Grims, Peter MD Huang, Enoch MD, MPH, Grims, Peter MD “Forearm Fractures” “Forearm Fractures”

Baniukiewied, Andrew P. MD, DiSandro, Baniukiewied, Andrew P. MD, DiSandro, Daniel MD “Broken Arm”Daniel MD “Broken Arm”

QuestionsQuestions

1. What is the difference between a closed 1. What is the difference between a closed fracture and an open fracture? fracture and an open fracture?

2. What are some external fixation 2. What are some external fixation methods?methods?

3. What are some external fixation 3. What are some external fixation methods?methods?

4. What is a comminuted fracture?4. What is a comminuted fracture? 5. Why do we call a greenstick fracture a 5. Why do we call a greenstick fracture a

greenstick fracture?greenstick fracture?