Fracture of Radius, Ulna, and Humerus

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Fracture of Radius, Ulna, and Humerus

• Elizabeth Travis
• Michael Snyder
• AH 322
• 10-22-03

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Causes of Radius and Ulna Fractures

• Falling on outstretched arm
• Direct blow
• Mountain biking
• Skateboarding
• Trauma
• Automobile accidents
• Child abuse

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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).

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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.

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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.

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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.

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Types Cont.
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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

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Treatment

• External fixation methods
• plaster and fiberglass casts
• cast-braces
• splints
• Internal fixation methods
• metal plates
• Pins
• screws

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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

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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.

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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.

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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

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References

• http//orthoinfo.aaos.org/fact/thr_report.cfm?Thre
  ad_ID326topcategoryArm
• Huang, Enoch MD, MPH, Grims, Peter MD Forearm
  Fractures
• Baniukiewied, Andrew P. MD, DiSandro, Daniel MD
  Broken Arm

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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?