Forearm Fracture, Shaft/distal

Description

• Forearm shaft fractures (single or paired) are often displaced by contraction of arm muscles; sometimes associated with concurrent dislocations:
  • Galeazzi fracture:
    • Distal radius fracture with distal radioulnar dislocation
  • Monteggia fracture:
    • Proximal ulnar fracture with dislocation of radial head
  • Essex-Lopresti fracture:
    • Comminuted radial head fracture with distal radioulnar dislocation
• Distal fractures include extension, flexion, and intra-articular classifications:
  • Colles fracture:
    • Hyperextension fracture of distal radius
    • Distal fragment displaced dorsally
    • Radial deviation
    • Often involves ulnar styloid and distal radioulnar joint
  • Smith fracture:
    • Hyperflexion fracture of distal radius
    • Distal fragment displaced volarly
  • Barton fracture:
    • Intra-articular fracture of dorsal rim of distal radius
    • Often associated with dislocation of carpal bones
  • Reverse Barton fracture:
    • Intra-articular fracture of ventral rim of distal radius
    • Often associated with dislocation of carpal bones
  • Hutchinson fracture:
    • Intra-articular fracture of radial styloid

• Shaft fractures:
  • Torus fracture:
    • Compression (buckling) of cortex on 1 or both sides
  • Greenstick fracture:
    • Distraction of 1 side of cortex with opposite side intact
  • Plastic deformity:
    • Bowing of radius or ulna without apparent disruption of cortex
    • Multiple microfractures
• Distal and proximal fractures:
  • Salter–Harris type fractures (see Salter–Harris Classification)

Etiology

• Direct blow to forearm
• Longitudinal compression load:
  • Fall on outstretched hand (FOOSH)
  • Horizontal force
• Excessive pronation, supination, hyperextension, or hyperflexion