Fracture of Radius, Ulna, and Humerus Elizabeth Travis Michael Snyder AH 322 10-22-03
Causes of Radius and Ulna Fractures • Falling on outstretched arm • Direct blow • Mountain biking • Skateboarding • Trauma • Automobile accidents • Child abuse
Types of Fractures • Nightstick fracture • Defined as an isolated midshaft ulnar fracture • Monteggia fracture • Defined as a fracture of the ulna (usually proximal one third) with dislocation of the radial head. • Galeazzi fracture • Defined as a fracture of the distal one third of the radius with dislocation of the distal radioulnar joint (DRUJ).
Types Cont. • It is also known as a reverse Monteggia fracture. • Essex-Lopresti fracture • 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. • Closed or simple fracture • The bone is broken, but the skin is not lacerated. • Open or compound fracture • 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. • Transverse fracture • The fracture is at right angles to the long axis of the bone. • Greenstick fracture • Fracture on one side of the bone, causing a bend on the other side of the bone. • Comminuted fracture • A fracture that results in three or more bone fragments.
Signs and Symptoms • Most of the time you will know if you have a broken arm • Snap or cracking sound • Area will be tender and swollen • Obvious deformity • Decreased sensation or inability to move the limb, which may indicate nerve damage
Treatment • External fixation methods • plaster and fiberglass casts • cast-braces • splints • Internal fixation methods • metal plates • Pins • screws
Treatment Cont’ • Keep your splint or cast clean and dry • If possible, apply ice 2-3 times a day • Keep your arm elevated above the heart as much as possible to decrease swelling • Take pain medicine as prescribed
Prognosis • Earlier treatment usually improves results • Fractures in younger children and adolescents tend to heal better • Fractures that have multiple breaks, involve a joint, have open wounds, or become infected could have healing complications.
Prognosis Cont’ • Older adults have increased chance of losing some ability or movement in the broken arm. • Chronic diseases such as osteoporosis and diabetes may slow the healing process.
Prevention • Wear appropriate personal safety equipment as protection. • Wear car seat belts • Use wrist guards for in-line skating and skateboarding • Wear appropriate pads for contact sports • Prevent and treat osteoporosis
References • http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=326&topcategory=Arm • Huang, Enoch MD, MPH, Grims, Peter MD “Forearm Fractures” • Baniukiewied, Andrew P. MD, DiSandro, Daniel MD “Broken Arm”
Questions • 1. What is the difference between a closed fracture and an open fracture? • 2. What are some external fixation methods? • 3. What are some external fixation methods? • 4. What is a comminuted fracture? • 5. Why do we call a greenstick fracture a greenstick fracture?