Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE.

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Presentation transcript:

Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE

FOREARM INJURIES Monteggia Fracture Proximal Radius Fracture Radius Ulna Fracture Ulna Fracture (Nightstick) Distal radius fracture and distal radioulna dislocation(Galeazzi #) Distal Radius # Distal radioulna joint injury

MONTEGGIA FRACTURE Proximal ulna # with proximal radioulna dislocation(Radius head-Anterior) Rx =Open reduction internal Fixation Cx =PIN injury, Redislocation,Subluxation or inadequate reduction

MONTEGGIA #

PROXIMAL RADIUS # Displaced/ Non displaced Rx=Non displaced =AE POP Slab- close follow up =Displaced=ORIF Complications=Malunion

RADIUS ULNA #” Displaced/ Non displaced Pattern of Fracture=transverse, oblique, spiral comminuted Complications=Acute-Compartment Sx -Vascular Injury -Pin injury Late=Non/mal union, synostosis and refracture

RADIUS AND ULNA #

NIGHTSTICK # Direct blow to ulna distal 1/3 Displaced or undisplaced Direct = transverse Associated rotational forces oblique therefore unstable Rx=undisplaced well moulded cast, displaced and unstable ORIF

NIGHTSTICK #

GALEAZZI # Distal 1/3 radius # with assoc-dislocation of distal radioulna joint/ instability AP – widening of DRUJ LAT-Dislocation of DRUJ Assoc ulna styloid # Shortening of Radial height by > 5mm Rx = ORIF plus supination or CRPP DRUJ CX=Mal/ Nan union, DRUJ subluxation

GALEAZZI #

COLLE”S # Pathological #-Osteoporotic bone Distal 2-3cm of distal radius Clinically = Dinner fork deformity X-R =PA- radial displacement & impaction may have associated ulna styloid =LAT- Dorsal displacement & apex volar displacement  COLLE”S TYPE #- SAME BUT NORMAL BONE

COLLE”S #

SMITH #

BARTON VOLAR BARTON DORSAL BARTON

RADIUS STYLOID # CHAUFFEUR “S # NB! Rule out scaphoid # Rx =ORIF General=Intra/extra articular and displaced/ undisplaced

DISTAL RADIOULNA JOINT INSTABILITY TFCC – ulna styloid # Evaluate- interosseus membrane, radius head ESSEX LOPRESTI lesion Rx-CRPOP in supination / CRPP if CRPOP does not achieve and maintain reduction

DRUJD/I AND CHAUFFEUR # DRUJICHAUFFEUR #

TERRY THOMAS

PERILUNATE DISLOCATION

SCAPHOLUNATE DISSOCIATION

THE END QUESTIONS COMMENTS THANK YOU