After completion of this session, students should be able to discuss, identify, and describe: The anatomical factors predisposing to the etiology of a fracture or dislocation. The anatomy of displacement or deformity. Imaging anatomy features and how to differentiate from epiphyseal lines. Anatomy related to correct relocation and alignment. Anatomical complications of a fracture or dislocation.

1. Dr.AkramJaffar
Imaging Anatomy of Fractures and Dislocations inImaging Anatomy of Fractures and Dislocations in
the Upper Limbthe Upper Limb
Fractures of the radiusFractures of the radius
Akram Jaffar, Ph.D.
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References and suggested reading
• Ellis H (2006): Clinical anatomy, A revision and applied anatomy for clinical students.
11th
Ed. Blackwell Publishing. Massachusetts.
• Moore KL et al. (2013): Clinically Orientated Anatomy. 7th Ed. Lippincott, Williams &
Wilkins. Philadelphia.
• Hamblen DL & Simpson HRW (2007): Adam’s outline of fractures including joint
injuries. 12th
ed. Churchill Livingstone Elsevier. Edinburgh.
• Solomon L, Warwick DJ & Nayagam S (2001): Apley's System of Orthopedics and
Fractures. 8th ed. Arnold Publishing.

3. Dr.AkramJaffar
Objectives
After completion of this session, students should be able to discuss, identify, and describe:
• The anatomical factors predisposing to the etiology of a fracture or dislocation.
• The anatomy of displacement or deformity.
• Imaging anatomy features and how to differentiate from epiphyseal lines.
• Anatomy related to correct relocation and alignment.
• Anatomical complications of a fracture or dislocation.

4. Dr.AkramJaffar
Radius fracture
• Anatomy of displacement and reduction:
pronator teres is inserted midway along the
radial shaft.
– If the radius is fractured proximal to this,
the proximal fragment is supinated by the
action of biceps and the distal fragment is
pronated by pronator teres. The fracture
must, therefore, be splinted with the
forearm supinated to align the distal
fragment with the supinated proximal end.
– If the fracture is distal to mid-shaft, the
actions of biceps and pronator muscles
balance. The fracture is therefore,
immobilized with the forearm in the
neutral position (mid-prone).
Pronator
teres
Biceps
brachii
supination
pronation

5. Dr.AkramJaffar
Colle’s fracture
• Most common fracture in civilian
practice.
• Fracture of the distal end of the
radius.
• Anatomy of displacement:
– The distal fragment is displaced
proximally causing shortening
of the radius.
– The characteristic relation of
the ulnar and radial styloid
processes is lost.
normal
fracture
Ulnar styloid
Radial styloid

6. Dr.AkramJaffar
Colle’s fracture
• Anatomy of displacement:
– the distal fragment is tilted
posteriorly producing the
characteristic "silver fork"
deformity
– extensors and abductors of the
thumb pull the distal fragment
of the radius proximally.
Extensor pollicis longus
Ext. pollicis Br.
Abd. pollicis Long.

7. Dr.AkramJaffar
Colle’s fracture Median n.
Median n.
• Anatomical complications
• Injury of the median nerve by the distal end of the proximal
fragment.
• Rupture of the tendon of extensor pollicis longus  mallet
thumb:
– The tendon takes a sharp bend around the radial
tubercle, thus it bears heavily against the bone as it
glides to and fro.
Extensor pollicis longus
Mallet thumb