Forearm Bone Shaft Fractures Quiz
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Questions and Answers

What are the primary focuses of physical therapy in the early rehabilitation of CRPS?

The primary focuses are pain and edema control, along with mobilizing the upper limb to regain normal range of motion.

How does mirror therapy assist patients recovering from injuries?

Mirror therapy helps by creating a visual feedback of the unaffected hand, which can stimulate movement and reduce pain perception.

What is the purpose of desensitization in physical therapy?

Desensitization aims to reduce sensitivity by using stimuli of different fabrics, pressures, vibrations, and temperatures.

Describe how a Colles cast is applied.

<p>A Colles cast is applied with the distal fragment in slight palmar flexion and ulnar deviation to stabilize the fracture.</p> Signup and view all the answers

What is indicated for the rehabilitation process 7 to 8 weeks post-fracture?

<p>Mobilization of the wrist is indicated approximately 7 to 8 weeks post-fracture to restore range of motion.</p> Signup and view all the answers

In what situation is an open reduction and internal fixation necessary?

<p>An open reduction and internal fixation are required for significant angulation and deformity of a fracture.</p> Signup and view all the answers

What is the significance of early mobilization after surgical treatment of a wrist fracture?

<p>Early mobilization helps to regain range of motion quicker and prevents stiffness in the wrist joint.</p> Signup and view all the answers

What distinguishes a Smith fracture from a Colles fracture?

<p>A Smith fracture is characterized by anterior displacement of the distal fragment, while a Colles fracture has dorsal displacement.</p> Signup and view all the answers

What is the primary complication associated with a Colles fracture regarding the radial artery?

<p>Radial artery injury is a primary complication associated with a Colles fracture.</p> Signup and view all the answers

List two early complications of a Colles fracture.

<p>Two early complications include carpal tunnel syndrome and extensor pollicis longus injury.</p> Signup and view all the answers

Describe the term 'malunion' in the context of a Colles fracture.

<p>Malunion refers to the healing of a Colles fracture with residual malalignment, causing a loss of wrist flexibility.</p> Signup and view all the answers

What long-term complication can develop due to malunion of a Colles fracture?

<p>Osteoarthritis can develop as a long-term complication due to malunion of a Colles fracture.</p> Signup and view all the answers

Explain what Complex Regional Pain Syndrome (CRPS) is.

<p>CRPS is a chronic pain condition affecting an arm or leg, usually after an injury or surgery, characterized by pain disproportionate to the initial injury.</p> Signup and view all the answers

What role does early intervention play in the treatment of CRPS?

<p>Early intervention, including physical therapy and anti-inflammatory agents, is crucial for managing CRPS effectively.</p> Signup and view all the answers

Identify one factor that may lead to the onset of CRPS.

<p>CRPS may develop following an initial injury, surgery, stroke, or heart attack.</p> Signup and view all the answers

What are the symptoms of Reflex Sympathetic Dystrophy Syndrome (RSDS)?

<p>Symptoms of RSDS include intense pain, swelling, skin discoloration, and restricted movement.</p> Signup and view all the answers

What is a Monteggia fracture and how does it typically present?

<p>A Monteggia fracture is a fracture of the upper third of the ulna with anterior displacement of the upper ulna fragment and anterior dislocation of the radius.</p> Signup and view all the answers

Describe the characteristics of a Galeazzi fracture-dislocation.

<p>A Galeazzi fracture-dislocation involves a fracture of the distal third of the radius with dislocation or subluxation of the inferior radioulnar joint.</p> Signup and view all the answers

What are the key rehabilitation phases for a patient with a both bone forearm fracture?

<p>The rehabilitation phases are: Phase I (0-2 weeks): splinting and edema control; Phase II (2-6 weeks): active-assisted ROM; Phase III (6 weeks and beyond): lifting restrictions lifted after union.</p> Signup and view all the answers

What causes a Colle's fracture and who is most likely to be affected?

<p>A Colle's fracture is typically caused by a fall on a dorsiflexed wrist and it mainly affects older individuals, particularly women due to osteoporosis.</p> Signup and view all the answers

Explain the mechanism of injury commonly associated with Galeazzi fractures.

<p>Galeazzi fractures are commonly caused by a rotational force that results in swelling of the lower forearm and prominent head of the ulna.</p> Signup and view all the answers

What complications may arise if a Monteggia fracture is not treated surgically?

<p>If a Monteggia fracture is not treated surgically, it may redisplace, leading to potential complications such as improper healing and loss of joint function.</p> Signup and view all the answers

How does the positioning of a Colle's fracture typically appear on physical examination?

<p>The typical position of a Colle's fracture shows the distal fragment displaced radially and rotated in a supinatory direction, creating a 'dinner fork' deformity.</p> Signup and view all the answers

What is the recommended approach for edema control during the initial phase of rehabilitation for forearm fractures?

<p>Edema control should include elevation of the extremity and may also involve the use of splints to minimize swelling.</p> Signup and view all the answers

Study Notes

Forearm Bone Shaft Fractures

  • Monteggia fracture: A fracture of the upper third of the ulna with anterior displacement of the upper ulnar fragment and anterior dislocation of the radius. It's also a proximal ulnar fracture with superior radio-ulnar joint dislocation. Requires ORIF (open reduction and internal fixation) to avoid redisplacement.

  • Galeazzi fracture-dislocation: A fracture of the distal one-third of the radius with dislocation or subluxation of the inferior radioulnar joint. It is typically caused by rotational forces. Symptoms include swelling in the lower forearm, a prominent ulna head, and ulnar nerve injury. Non-operative treatment may lead to redisplacement, so surgical intervention is often required.

Distal Radial Fractures

  • Colles' fracture: A transverse fracture of the distal radius, usually 2 cm proximal to the radiocarpal joint. It's one of the most common fractures affecting primarily older people, especially women due to osteoporosis. It results from a fall on a dorsiflexed (extended) wrist, often causing a "dinner fork" deformity.

  • Smith's fracture: Also known as reverse Colles' fracture or a Goyrand fracture. This fracture is the opposite of a Colles' fracture, resulting in anterior (palmar) displacement of the distal radius fragment. The fracture occurs proximally to the wrist joint, resulting in a fall on a flexed wrist. It typically causes a "garden spade" deformity.

  • Barton's fracture-dislocation: An intra-articular distal radius fracture with either volar or dorsal displacement. Management typically involves ORIF (open reduction and internal fixation).

  • Radial styloid fracture (chauffeur fracture): A fracture to the radial styloid process, often caused by compression from the scaphoid bone. Non-displaced fractures are treated with cast immobilization; displaced fractures require surgical fixation.

Fracture Rehabilitation

  • Phase I (weeks 0-2): Focus on protecting surgical incisions, elevating the affected extremity to reduce swelling, and controlling edema. Sutures or staples are removed at week two.

  • Phase II (weeks 2-6): Emphasize active and active-assisted range of motion (ROM) exercises for the elbow, forearm, and wrist. Avoid repetitive twisting motions of the forearm.

  • Phase III (weeks 6+): Lifting and twisting restrictions are lifted once bone union has occurred. Focus on regaining preoperative mobility and weight-bearing restrictions can also be removed following consultations with the treating surgeon. Work on increasing range of motion and performing strengthening exercises.

Complications

  • Early Complications (Colles' fracture): Radial artery injury, carpal tunnel syndrome, extensor pollicis longus injury.

  • Late Complications (Colles' fracture): Malunion (poor bone healing), joint stiffness, Volkmann ischemic contracture, osteoarthritis, and Sudeck's osteodystrophy (complex regional pain syndrome).

  • Malunion: A Colles' fracture rarely heals without some residual malalignment. The radius often becomes foreshortened, the radial styloid process may be shortened, and the distal end of the radius is commonly angulated and displaced dorsally. This malalignment may lead to permanent losses of wrist flexion and ulnar deviation, and pronation. Radial displacement may also have a minor impact on motion.

Reflex Sympathetic Dystrophy (RSD) 

  • RSD is a clinical syndrome of variable course and unknown cause characterized by pain, swelling, and vasomotor dysfunction in an extremity.

  • The pain is usually disproportionate to the initial injury(surgery, stroke, heart attack).

  • Treatment involves early recognition, early intervention with physical therapy, and use of anti-inflammatory agents and nerve blocks.

  • Physical therapy for RSD focuses on pain and edema control, active upper limb exercises (with automated passive exercises to improve range of motion). Functional activities are also considered, as well as aquatic therapy, mirror therapy (to improve mirror feedback and desensitize the injury through stimuli), and desensitization techniques (applying varying pressures, stimuli of varying materials, heat or cold therapy).

Treatment of Forearm Fracture

  • Undisplaced fracture: Can be treated by cast immobilization, specifically a cast applied to a wrist angled slightly palmarly, with an ulnar deviation, also known as a colles cast.

  • Fractures with mild angulation and displacement: Requires closed reduction.

  • Fractures with significant angulation and deformity: Requires open reduction and internal fixation or external fixation.

Physical Therapy Guide

  • Early focus: Limiting pain and edema in the wrist and hand. Emphasize movement in the shoulder, elbow, and fingers in all rehabilitation phases.

  • Mobilizing the Wrist: Mobilization focus can occur 7-8 weeks after fracture. Early mobilization can start a week after surgery if internal fixation is applied.

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Forearm Bone Shaft Fracture PDF

Description

Test your knowledge on forearm bone shaft fractures including Monteggia and Galeazzi fractures. This quiz covers their definitions, causes, symptoms, and treatments. Ideal for medical students and professionals looking to refresh their understanding of these common injuries.

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