This volar approach of Henry is extensile as well. Distal radial shaft fractures are usually approached through a volar incision. Fractures of the proximal radial shaft are most often approached dorsally with a Thompson approach, which can be extensile if necessary. The surgical approach depends on a number of variables including fracture location.
Generally the standard of care for radial shaft fractures is open reduction and internal fixation with 3.5mm dynamic compression plating is the treatment of choice. Also the multi-trauma patient in extremis is another possible indication for damage control orthopaeidcs. Open fractures with severe soft tissue injury in isolated radial shaft fractures (as opposed to both bone forearm fractures) may be initially treated with temporizing external fixation. After swelling subsides a long arm cast can be implemented, but there is a risk of loss of motion at the elbow with this type of immobilization. Nonetheless in the instance of nondisplaced radial shaft fractures, initial immobilization in a sugar tong splint is warranted as a treatment option. Non-operative treatment of radial shaft fractures is rare and outcomes of nonsurgical treatment in the past have been poor (see Outcomes below). Radiographs aid in identifying the location of the fracture and assist in treatment plans including surgical approach.
#GALEAZZI FRACTURE ORTHOBULLETS FREE#
Range of motion of both the wrist and elbow should be pain free in the specific joint. The elbow and wrist need to be evaluated for associated injuries including ligamentous instability such as the Galeazzi pattern described above. Diagnosisĭiagnosis of a radial shaft fracture comes from a history, physical examination and AP and lateral radiographs of the elbow, forearm and wrist. The thumb extensors can also shorten the shaft.
The radial shaft also has a slight curve producing a medial concave border.ĭeforming forces on the radial shaft come from the brachioradialis which pull the distal fragment proximal and the pronator quadratus which pronates the fragment and pulls it proximal and volar. The radial shaft is mostly round in cross section with the exception of the interosseous margin or crest where the interosseous membrane attaches to the shaft. The radius is the shorter of the two bones in the forearm and it lies lateral to the ulna. Both isolated radial shaft fractures and Galeazzi fractures require open reduction and internal fixation (ORIF) to achieve satisfactory outcomes.
A radial shaft fracture with DRUJ instability is referred to as Galeazzi fractures.
#GALEAZZI FRACTURE ORTHOBULLETS FULL#
Isolated radial shaft fractures require full evaluation and documentation of distal radial ulnar joint (DRUJ) stability. These injuries usually occur from either a direct blow to the forearm or a fall on outstretched hands (FOOSH). Isolated fractures of the radial shaft (proximal two-thirds) are less common than distal radius fractures.
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