Forearm Fracture, Shaft/distal

Forearm Fracture, Shaft/distal is a topic covered in the 5-Minute Emergency Consult.

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  • 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
  • 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
    • Hutchinson fracture:
      • Intra-articular fracture of radial styloid

Pediatric Considerations
  • 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 fractures:
    • Salter–Harris type fractures (see Salter–Harris classification)


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

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