Radia ulna fracture
Background
- Requires great amount of force (vehicular trauma, falls from height, direct blow)
- Neurovascular complications are unusual
- One of the most common pediatric fractures
Clinical Features
- Pain/swelling, deformity
- Point tenderness
Differential Diagnosis
Forearm Fractures
- Distal radius fractures
- Colles' fracture
- Smith fracture
- Barton fracture
- Radial styloid fracture
- Distal radioulnar joint disruption
- Radia ulna fracture
- Isolated radius fracture (proximal)
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Forearm fracture (peds)
Evaluation
- Assess distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
Imaging
- Always consider wrist and elbow films
- Assess for angulation
- AP view: radial styloid and radial tuberosity normally point in opposite directions
- Lateral view: ulnar styloid and coronoid process normally point in opposite directions
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
- Splint
Disposition
- If splinted and stabilized, can be discharged with orthopedic followup
- Admit for:
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome
Specialty Care
- Frequently ORIF
See Also
References
This article is issued from
Wikem.
The text is licensed under Creative
Commons - Attribution - Sharealike.
Additional terms may apply for the media files.