FOREARM SHAFT FRACTURES

BY-Dr. PRAKHAR CHHAWCHHARIAMCh(ORTHO),D(ORTHO), MBBS

FELLOWSHIP IN ARTHROSCOPY

INTRODUCTIONINCIDENCE

BIMODAL PEAK OF INCIDENCE 10:10000YOUNG MALES AND ELDERLY FEMALES

MECHANISM OF INJURYDIRECT TRAUMA- SELF DEFENSEINDIRECT TRAUMA- RTA, SPORTS INJURY,

FALL

ASSOCIATED INJURYGALEAZZI FRACTURE/MONTEGGIACOMPARTMENT SYNDROME

SURGICAL ANATOMY

5 BANDS OF INTEROSSEOUS MEMBRANE

DORSAL OBLIQUE BAND

CENTRAL BAND

ACCESSORY BAND

DORSAL OBLIQUE ACCESSORY CORD

PROXIMAL OBLIQUE CORD

SURGICAL ANATOMYIMP STRUCTURES WHILE USING THE

VOLAR HENRY’S APPROACH TO RADIUS- bicep’s tendon to radial styloid

1. BRACHIORADIALIS- RADIAL NERVE2. PRONATOR TERES- MEDIAN NERVE3. FLEXOR CARPI RADIALIS – MEDIAN

NERVE4. PIN- SUPINATOR MUSCLE5. SUPERFICIAL RADIAL NERVE6. RADIAL ARTERY

SURGICAL ANATOMY

SURGICAL ANATOMYIMP STRUCTURES WHILE USING THE

POSTEROLATERAL THOMPSON’S APPROACH-Lateral epicondyle to lister’s tubercle

Superficial radial nerve Cephalic veinExtensor carpii radialis brevisExtensor digitorum communisPronator teresSupinator-PINAbdutor pollicis longus

SURGICAL ANATOMY

SURGICAL ANATOMYIMP STRUCTURES WHILE USING DIRECT

APPROACH TO ULNA- Olecranon to ulna styloid

EXTENSOR CARPI ULNARISFLEXOR CARPI ULNARISDISTALLY PROTECT THE DORSAL BRANCH

OF ULNAR NERVE

SURGICAL ANATOMY

CLASSIFICATIONDESCRIPTIVE1. OPEN VS CLOSED2. LOCATION3. DISPLACEMENT4. ANGULATION5. COMMINUTION, SEGMENTAL,

MULTIFRAGMENTED

OTA CLASSIFICATION

CLINICAL EXAMINATIONPAIN, DEFORMITY, SWELLINGH/O TRAUMAIF PAIN ON PASSIVE STRETCH OF

FINGERS- EVALUATE FURTHER FOR COMPARTMENT SYNDROME

OPEN INJURIES/FOREIGN CONTAMINANTASSESS RADIAL,MEDIAN & ULNAR NERVE

FUNCTIONCHECK RADIAL AND ULNAR PULSES

TREATMENTNON OPERATIVE1. WELL MOULDED CAST WITH GOOD

INTEROSEOUS MOULD IN ISOLATED UNDISPLACED RADIUS OR DISTAL 2/3 ULNA NIGHT STICK INJURY

OPERATIVE1. ORIF WITH 3.5MM DCP2. ORIF WITH LOCKING PLATE3. ORIF WITH BONE GRAFTING4. EXTERNAL FIXATOR IN GUSTILLO TYPE

IIIB/IIIC