1. Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE

2. 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

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

4. MONTEGGIA #

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

6. 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

7. RADIUS AND ULNA #

8. 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

9. NIGHTSTICK #

10. 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

11. GALEAZZI #

12. 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

13. COLLE”S #

14. SMITH #

15. BARTON VOLAR BARTON DORSAL BARTON

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

17. 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

18. DRUJD/I AND CHAUFFEUR # DRUJICHAUFFEUR #

19. TERRY THOMAS

20. PERILUNATE DISLOCATION

21. SCAPHOLUNATE DISSOCIATION

23. THE END QUESTIONS COMMENTS THANK YOU