![]() The majority (60%) of these injuries involve anterior dislocation of the radial head. ![]() With Forearm Fractures, Associated Injuries May Occur In The Elbow And Wrist.Ī Monteggia fracture is a fracture of the proximal ulna with an associated radial head dislocation ( Fig. These Fractures May Be Classified According To Their Occurrence On The Proximal, Middle, Or Distal Shafts Of The Radius And Ulna. It Is Important To Recognize That The Forearm, Which Consists Of The Radius And Ulna, Acts As A Ring And That Dissipation Of Energy Results In Fractures Or Dislocations Of Both Bones In Most Cases. Fractures Of The Forearm Are Most Often Due To Direct Blows, Although They May Also Occur With Falls Onto An Outstretched Hand. Check for open wounds on the forearm, because these injuries are frequently open fractures.The presence of a radial pulse does not rule out compartment syndrome capillary blood flow ceases at a pressure lower than arterial blood flow. The increased pressure inside the forearm is diminishing the blood flow to the extremities. The most sensitive clinical test for this is pain with passive extension of the fingers. It is essential to document the neurovascular examination carefully. However, this may not be present in dark-skinned patients. The damaged extremity usually demonstrates pallor in fair-skinned individuals. Neurovascular impairment may occur as the result of a compartment syndrome or from direct trauma to the neurovascular structures. In addition, accompanying sensory abnormalities which are characterized by decreased pinprick and light touch are common findings as well. Motor strength will be severely affected and will be absent or pain limited. With neurovascular damage, the patient will manifest diminished or absent pulses. It is important to pay special attention to the radial, ulnar, and median nerves, including evaluation of the anterior interosseous and posterior interosseous nerve branches. conduct a thorough neurovascular examination.palpate the wrist, elbow, and shoulder to assess for associated injuries, because often these fractures are a result of high-speed injury.Forearm fractures are often open fractures.ĭuring physical examination for patients with all types of forearm injuries, the physician should.A fracture of the proximal (or middle ulna) is associated with a dislocation of the radial head.
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