Distal forearm fractures and dislocations

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Distal forearm fractures and dislocations

• Dr. Ihab Rassem
• Lecturer of Radiology
• Ain Shams University
• Cairo, Egypt

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Radiography

• PA Lateral are sufficient in most cases

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Radiographic anatomy
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Neutral Ulnar variance
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Negative Positive
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Ulnar slant of articular surface of
radiusMeasured on PA view
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Palmar inclination angleMeasure on Lateral view
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Fracture types

1. Colles Fracture
2. Smith Fracture
3. Barton fracture
4. Hutchinson fracture
5. Essex-Lopresti fracture dislocation
6. Galeazzi fracture dislocation

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Colles Fracture

• Most frequently encountered injury to the distal
  forearm.
• Fall on the outstretched hand with forearm
  pronated in dorsiflexion.
• Age usually above 50y FgtM.
• Extraarticular 2-3 cm away from articular surface
  of radius.
• Associated of ulnar styloid process

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Smith Fracture

• Fracture of the distal radius with volar
  displacement and angulation of the distal
  fragment
• Results from a fall on the back of the hand or a
  direct blow to the dorsum of the hand.
• Often referred to as a reverse Colles fracture.

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Smith Fracture
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Barton Fracture

• Fracture of dorsal margin of the distal radius
  extending into the radiocarpal articulation.
• Reverse (or volar) Barton fracture when it
  involves the volar aspect of distal radius

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Barton Fracture
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Reverse Barton
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Hutchinson Fracture

• Also known as chauffeur's fracture.
• Involves the lateral margin of the distal radius,
  extending through the radial styloid process into
  the radiocarpal articulation .
• Best seen in PA view

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Hutchinson Fracture
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Essex-Lopresti Fracture-Dislocation

• Complex type injury which comprises
• Comminuted fracture of the radial head and neck
  /- distal extension.
• Tear of the interosseous membrane.
• Dislocation in the distal radioulnar joint.

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Galeazzi FractureDislocation

• This injury type comprises-
• Fracture of the distal third of the radius,
• Dislocation in the distal radioulnar joint.

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