Distal forearm fractures and dislocations

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Presentation transcript:

Distal forearm fractures and dislocations Dr. Ihab Rassem Lecturer of Radiology Ain Shams University Cairo, Egypt

Radiography PA & Lateral are sufficient in most cases

Radiographic anatomy

Neutral Ulnar variance

Negative Positive

Ulnar slant of articular surface of radius Measured on PA view

Palmar inclination angle Measure on Lateral view

Fracture types Colles Fracture Smith Fracture Barton fracture Hutchinson fracture Essex-Lopresti fracture dislocation Galeazzi fracture dislocation

Colles Fracture Most frequently encountered injury to the distal forearm. Fall on the outstretched hand with forearm pronated in dorsiflexion. Age usually above 50y; F>M. Extraarticular 2-3 cm away from articular surface of radius. Associated # of ulnar styloid process

Smith Fracture Fracture of the distal radius with volar displacement and angulation of the distal fragment Results from a fall on the back of the hand or a direct blow to the dorsum of the hand. Often referred to as a reverse Colles fracture.

Smith Fracture

Barton Fracture Fracture of dorsal margin of the distal radius extending into the radiocarpal articulation. Reverse (or volar) Barton fracture: when it involves the volar aspect of distal radius

Barton Fracture

Reverse Barton

Hutchinson Fracture Also known as chauffeur's fracture. Involves the lateral margin of the distal radius, extending through the radial styloid process into the radiocarpal articulation . Best seen in PA view

Hutchinson Fracture

Essex-Lopresti Fracture-Dislocation Complex type injury which comprises Comminuted fracture of the radial head and neck +/- distal extension. Tear of the interosseous membrane. Dislocation in the distal radioulnar joint.

Galeazzi Fracture–Dislocation This injury type comprises:- Fracture of the distal third of the radius, Dislocation in the distal radioulnar joint.

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