Forearm and Elbow Fractures PDF

‫بسم‬ ‫هللا‬ ‫الرحمن‬ ‫الرحيم‬ Elbow And Forearm fractures By Prof. Dr Mohamad Abdelhamid  Anatomy of fore arm A) Elbow region: 1- Distal Humerus 2- Head Of radius 3- Olecranon B) Mid shaft: 1- Radius 2-Ulna C) Wrist region 1- Distal Radius 2- Head of Ulna  Mecha...

‫بسم‬ ‫هللا‬ ‫الرحمن‬ ‫الرحيم‬ Elbow And Forearm fractures By Prof. Dr Mohamad Abdelhamid  Anatomy of fore arm A) Elbow region: 1- Distal Humerus 2- Head Of radius 3- Olecranon B) Mid shaft: 1- Radius 2-Ulna C) Wrist region 1- Distal Radius 2- Head of Ulna  Mechanism of Trauma  Falling on the ground (extended or flexed)  Motor Car Accident  Wind swept injury (elbow on the edge of car window)  Clinical picture  History  Age (infant, child, and adult)  Duration of fracture  skin condition  Distal Nurovascular condition  general condition of the patient.  General principles  Clinical assessment  Clear X rays  Identification of Fracture site  Classification  Intra-articular fr. Must be anatomically reduced  Facilities available (X-rays, operation theater, instruments, and experties)  Follow up  Elbow region A) Fracture distal Humerus  1- Supracondylar Fracture humerus (SCFH)  Elbow region A) Fracture distal Humerus  2- Fr. Lat condyle  3- Fr. Med. Condyle Humerus Humerus  Elbow region B) Fracture Olecranon  Elbow region C) Fracture Head of Radius Fracture head radius ♥ Intra-articular fr. ♥ Treatment : - large fragment : I.F. - comminuted fr. : excision, or arthroplasty: head prosthesis  Comminuted fracture head of radius: Arthroplasty; small difference than excision & only indicated in unstable elbow Fractures Mid shaft Radius and Ulna Monteggia Fracture-Dislocation ♥ FR. upper 1/3 ulna + dislocation of the superior R-U joint. ♥ Types : - extension type - flexion type - lateral type ♥ Treatment : O.R.I.F. of the ulna. Galeazzi Fracture- Dislocation  fracture of the distal third of the shaft of the radius and dislocation of the distal radioulnar joint  Treatment: Open Reduction Internal Fixation of the radial fracture plating  Wrist region Fracture distal Radius Colles’ fracture ♥ Fr. distal 1 inch of the radius, with or without avulsion of the ulnar styloid. ♥ Common in old age due to osteoporosis. Displacement of the distal fragment : ♥ Backwards, upwards, and laterally. ( displacement and tilt ) ♥ Clinically : - pain, tenderness……. - dinner-fork deformity. Treatment: Closed reduction & Plaster cast for 5 w. Fracture scaphoid ♥ may be impacted, not evident early in x-ray. ♥ Clinically : max. tenderness in snuff-box ♥ Treatment: immobilization in scaphoid cast. ♥ Complications : - non-union and AVN of prox. fragment. * Treatment of non-union : - I.F.+ B.G. - Proximal raw carpectomy - late cases with O.A. wrist: arthrodesis. Fractures of the metacarpals and phalanges : ♥ Easily treated by : - closed reduction to correct deformity + K wire fixation. _ miniplate Dislocation of joints  Complications  Complic. Of Trauma (open Fr, Nerve inj or compression, vascular inj or compartment)  Complications of treatment (infection, nerovascular inj, or tight cast)  Complications of healing (malunited fr. Or ununited fracture, and stiff joints) Thank you