dr r shadi ngobeni trauma consultant students lecture
DESCRIPTION
Dr R Shadi Ngobeni Trauma Consultant STUDENTS LECTURE. 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. - PowerPoint PPT PresentationTRANSCRIPT
Dr R Shadi NgobeniTrauma ConsultantSTUDENTS LECTURE
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
MONTEGGIA FRACTURE
• Proximal ulna # with proximal radioulna dislocation(Radius head-Anterior)
• Rx =Open reduction internal Fixation• Cx =PIN injury, Redislocation ,Subluxation or
inadequate reduction
MONTEGGIA #
PROXIMAL RADIUS #
• Displaced/ Non displaced• Rx=Non displaced =AE POP Slab- close follow
up =Displaced=ORIF• Complications=Malunion
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
RADIUS AND ULNA #
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
NIGHTSTICK #
GALEAZZI #
• Distal 1/3 radius # with assoc-dislocation of distal radioulna joint/ instability
AP – widening of DRUJLAT-Dislocation of DRUJAssoc ulna styloid #Shortening of Radial height by > 5mm• Rx = ORIF plus supination or CRPP DRUJ• CX=Mal/ Nan union, DRUJ subluxation
GALEAZZI #
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 displacementCOLLE”S TYPE #- SAME BUT NORMAL BONE
COLLE”S #
SMITH #
BARTON
VOLAR BARTON DORSAL BARTON
RADIUS STYLOID #
• CHAUFFEUR “S #• NB! Rule out scaphoid #• Rx =ORIF• General=Intra/extra articular and displaced/
undisplaced
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
DRUJD/I AND CHAUFFEUR #
DRUJI CHAUFFEUR #
TERRY THOMAS
PERILUNATE DISLOCATION
SCAPHOLUNATE DISSOCIATION
THE END
• QUESTIONS• COMMENTS
• THANK YOU