Distal radius fracture
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The document discusses the anatomy, epidemiology, classification, diagnosis, and management of distal radius fractures. Some key points: - The distal radius is responsible for 80% of the wrist's axial load and articulates with the scaphoid, lunate, and ulna. - Distal radius fractures have a trimodal distribution and are the most common osteoporotic fracture. - Types include Colles', Smith's, Barton's, and lunate load fractures. Colles' involves backward displacement and Smith's involves palmar displacement. - Treatment depends on factors like age, fracture characteristics, and associated injuries. Non-operative options include closed reduction and casting while operative options include pinning, external
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Distal radius fractures are common injuries that can lead to functional impairment. They are classified based on articular involvement, displacement, and comminution. Radiographs are used to evaluate factors like radial height, inclination, tilt, and step-off. Computed tomography may be needed for complex intra-articular fractures. Treatment goals are to restore anatomy, promote healing, and allow early motion to prevent complications.
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This document discusses distal radius fractures, providing details on:
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- Classification systems including Gartland & Werley and AO/OTA.
- Treatment options including casting, percutaneous pinning, plating techniques, external fixation.
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- Goals of treatment which are to preserve function, realign anatomy and promote healing.
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upper limb trauma.pptx
1. The document discusses various types of upper limb trauma including fractures of the clavicle, humerus, forearm, and distal radius as well as dislocations of the shoulder and elbow.
2. Key fracture classifications discussed include the Allman classification for clavicle fractures, Neer classification for proximal humerus fractures, and Bado's classification for Monteggia fractures.
3. Common mechanisms of injury involve falls onto an outstretched arm. Imaging workup involves radiographs to identify fracture patterns and displacements.
A brief review of distal radius fractures
This document provides an overview of distal radius fractures, including:
- Classifications including Frykman, Fernandez, Melone, AO which describe fracture type, severity and treatment.
- Common fracture types like Colles, Smith's and Barton's are described.
- Radiographic parameters to assess fracture reduction are outlined.
- Management approaches including closed reduction and casting, percutaneous pinning, external fixation and open reduction internal fixation are discussed. Complications of different treatment methods are also reviewed.
upper limb trauma.pptx
1) Clavicle fractures are most commonly caused by falls onto the shoulder. Treatment is usually closed with immobilization, though surgery may be used for displaced or unstable fractures.
2) Proximal humerus fractures are also often caused by falls, and are evaluated clinically and radiographically. Treatment depends on fracture type and degree of displacement, ranging from immobilization to open reduction and internal fixation.
3) Shoulder dislocations, especially anterior dislocations, commonly cause Bankart lesions of the labrum and Hill-Sachs defects of the humeral head. Early surgical repair may be needed for recurrent instability.
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Distal radius fracture
- 1. Insha Aleena Distal Radius Fracture
- 2. Anatomy • Responsible for 80% of axial load of wrist. • Articulates with: - Scaphoid - Lunate • Main associations: 1. Radioulnar joint 2. Sigmoid notch 3. Lunate fossa 4. Scaphoid fossa
- 3. • Watershed line: -most volar projection of distal radius -not covered by pronator quadratus -plate should not be placed beyond this line
- 4. Three Column Theory • Lateral: scaphoid fossa and styloid process • Intermediate: Lunate facet • Medial: Ulna and TFCC
- 5. Normal Radiographic Measurements of Distal Radius • Distal radio-ulnar joint congruity can be seen by the following measurements:
- 6. Radial Length Palmar Tilt Acceptable range: 10 to 12 mm Acceptable range: 11 to 12 degrees
- 7. Radial Inclination Ulnar Variance Acceptable range: 20 to 23 degrees Acceptable range: 0 to 2mm
- 9. Epidemiology of Distal Radius Fracture • 1/6th of all fractures • Trimodal distribution: -Paediatric (upto 14 years of age) -Women (>40 years of age) -Men (upto 50 years of age) • Most common osteoporotic fracture
- 10. Clinical Features • History of a fall onto outstretched hand (FOOSH) • Wrist pain and swelling • Wrist deformity • Visible deformity if displaced • Motion limited by pain • Ecchymosis • Diffuse tenderness
- 11. Types • Colle’s fracture • Smith’s fracture • Barton’s fracture • Chauffeur’s fracture/Hutchinson’s fracture • Die punch fracture/lunate load fracture
- 12. Colle’s Fracture • The most common type. • It is a distal radius fracture in the wrist, has a characteristic backwards displacement of the hand. • This fracture some times is referred to as “dinner fork” deformity, due to the shape of the fractured forearm. Dinner-fork Deformity
- 13. Smith’s Fracture • Is an extra articular transverse fracture that is palmarly displaced and can be thought of as a reverse Colle’s fracture. • Distal fragment displaced in palmar (volar) direction with a "garden spade" deformity.
- 14. Other Radial Fractures • Barton’s Fracture: intra-articular fracture, dislocation or subluxation in which the rim of the distal radius, dorsally or volarly is displaced with the hand and carpus. • Chauffeur’s Fracture: intra-articular fracture involving the radial styloid, the radius is cleaved in a sagittal plane and the fragment is displaced proximally. • Lunate Fracture: intra-articular fracture with displacement of the medial articular surface which usually represents a depression of dorsal aspect of lunate fossa.
- 17. Fernandez’s Classification • Bending- metaphysis fails under tensile stress (Colles, Smith). Extra-articular. • Shearing- fractures of joint surface (Barton, radial styloid). Intra articular.
- 18. • Compression - intra-articular fracture with impaction of subchondral and metaphyseal bone (die-punch). Complex articular fracture & radial pilon fracture. • Avulsion- fractures of ligament attachments (ulna, radial styloid) • Combined complex - high velocity injuries
- 19. Diagnosis and Imaging Radiographs Plain radiographs of an impacted distal radius A. Anteroposterior B. Lateral C. Oblique Acceptable radiographic parameters for a healed radius in an active healthy patient: • Radial length: within 2-3mm of contralateral wrist. • Palmar tilt: neutral tilt (0 degrees) • Radial inclination: >15 degrees • Intra-articular step-off: <2mm • DRUJ congruent
- 20. CT indications: • evaluate intra-articular involvement • surgical planning MRI indications: • evaluate for soft tissue injury -TFCC injuries -scapholunate ligament injuries (DISI) -lunotriquetral injuries (VISI)
- 21. Management • Treatment depends upon:- 1. Patient factors: -Age -Functional needs -Occupation -Handedness 2. Fracture personality -Displaced/Undisplaced -Intra/extra articular -Reducible/irreducible -Stable/unstable 3. Associated injuries
- 22. Treatment • Non-Operative: Closed reduction and splint/cast immobilisation. • Operative: 1. Percutaneous pinning 2. External fixation 3. Plating 4. IMIL nailing Closed Reduction of Colle’s fracture
- 23. Operative • Percutaneous pinning • External Fixation
- 24. • Plating • IMIL nailing
- 25. Thank You