Radiology Rounds: Forearm Fractures

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Information about Radiology Rounds: Forearm Fractures

Published on June 24, 2008

Author: radrounds

Source: slideshare.net

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Name those forearm fractures!

Brought to you by radRounds - social and professional networking for radiology.

Name that fracture Laura Avery, MD Massachusetts General Hospital Harvard Medical School Boston, MA, USA

 

Name that fracture… Galeazzi's Fracture/ Dislocation

Galeazzi's Fracture/ Dislocation

 

Name that fracture… Monteggia Fracture/Dislocation

Monteggia Fracture/Dislocation

Forearm Fracture/Dislocation MUGR (pneumonic) Monteggia= Ulna Galeazzi= Radius

MUGR (pneumonic)

Monteggia= Ulna

Galeazzi= Radius

Galeazzi's Fracture - frx of radial shaft (between middle and distal 1/3's) &   dislocation of distal radioulnar joint;             - usually the dislocation is dorsal, but in some cases can be palmar;             - frx is almost always located just above proximal border of pronator quadratus ;             - usually there is anterior angulation w/ transverse or short oblique config;       - injury to RU joint may be purely ligamentous (tearing the TFCC ), or the ligament complex may remain intact and             the ulnar styloid may be avulsed (in children there may be separation of the distal ulnar epiphysis);       - mechanism: usually direct blows and falls;       - displacing forces:             - wt of hand tends to cause subluxation of distal RU joint & dorsal angulation of the frx radius;             - insertion of pronator quadratus on palmar surface of distal fragment rotates it toward ulna & pulls it in prox & palmar direction;             - brachioradialis causes shortening & rotation of distal RU joint

- frx of radial shaft (between middle and distal 1/3's) &   dislocation of distal radioulnar joint;             - usually the dislocation is dorsal, but in some cases can be palmar;             - frx is almost always located just above proximal border of pronator quadratus ;             - usually there is anterior angulation w/ transverse or short oblique config;       - injury to RU joint may be purely ligamentous (tearing the TFCC ), or the ligament complex may remain intact and             the ulnar styloid may be avulsed (in children there may be separation of the distal ulnar epiphysis);       - mechanism: usually direct blows and falls;       - displacing forces:             - wt of hand tends to cause subluxation of distal RU joint & dorsal angulation of the frx radius;             - insertion of pronator quadratus on palmar surface of distal fragment rotates it toward ulna & pulls it in prox & palmar direction;             - brachioradialis causes shortening & rotation of distal RU joint

Monteggia Fracture/Dislocation Dislocation of radial head with fracture of ulnar diaphysis usually proximal 1/3. Eventhough frx of ulna is obvious need to look for radial head dislocation on all views, maybe subtle Line drawn thru radial shaft and radial head should align w/ capitellum in any position if the radial head is in normal position           - this is esp true on the lateral projection; Apex of angular deformity of ulna usually indicates direction of radial head dislocation Four Types : require ORIF

Dislocation of radial head with fracture of ulnar diaphysis usually proximal 1/3.

Eventhough frx of ulna is obvious need to look for radial head dislocation on all views, maybe subtle

Line drawn thru radial shaft and radial head should align w/ capitellum in any position if the radial head is in normal position           - this is esp true on the lateral projection;

Apex of angular deformity of ulna usually indicates direction of radial head dislocation

Four Types : require ORIF

 

 

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