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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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Rosen, Peter, et al., editors. "Forearm Fracture, Shaft/distal." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307706/all/Forearm_Fracture__Shaft_distal.
Forearm Fracture, Shaft/distal. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307706/all/Forearm_Fracture__Shaft_distal. Accessed April 26, 2019.
Forearm Fracture, Shaft/distal. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307706/all/Forearm_Fracture__Shaft_distal
Forearm Fracture, Shaft/distal [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307706/all/Forearm_Fracture__Shaft_distal.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Forearm Fracture, Shaft/distal ID - 307706 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307706/all/Forearm_Fracture__Shaft_distal PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -