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Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE

Dr R Shadi Ngobeni Trauma Consultant STUDENTS 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.

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Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE

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  1. Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE

  2. 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

  3. MONTEGGIA FRACTURE • Proximal ulna # with proximal radioulna dislocation(Radius head-Anterior) • Rx =Open reduction internal Fixation • Cx =PIN injury, Redislocation ,Subluxation or inadequate reduction

  4. MONTEGGIA #

  5. PROXIMAL RADIUS # • Displaced/ Non displaced • Rx=Non displaced =AE POP Slab- close follow up =Displaced=ORIF • Complications=Malunion

  6. 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

  7. RADIUS AND ULNA #

  8. 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

  9. NIGHTSTICK #

  10. GALEAZZI # • Distal 1/3 radius # with assoc-dislocation of distal radioulna joint/ instability • AP – widening of DRUJ • LAT-Dislocation of DRUJ • Assoc ulna styloid # • Shortening of Radial height by > 5mm • Rx = ORIF plus supination or CRPP DRUJ • CX=Mal/ Nan union, DRUJ subluxation

  11. GALEAZZI #

  12. 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 displacement • COLLE”S TYPE #- SAME BUT NORMAL BONE

  13. COLLE”S #

  14. SMITH #

  15. BARTON VOLAR BARTON DORSAL BARTON

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

  17. 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

  18. DRUJD/I AND CHAUFFEUR # DRUJI CHAUFFEUR #

  19. TERRY THOMAS

  20. PERILUNATE DISLOCATION

  21. SCAPHOLUNATE DISSOCIATION

  22. THE END • QUESTIONS • COMMENTS • THANK YOU

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