Forearm shaft fractures
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Transcript of Forearm shaft fractures
FOREARM SHAFT FRACTURES
BY-Dr. PRAKHAR CHHAWCHHARIAMCh(ORTHO),D(ORTHO), MBBS
FELLOWSHIP IN ARTHROSCOPY
INTRODUCTIONINCIDENCE
BIMODAL PEAK OF INCIDENCE 10:10000YOUNG MALES AND ELDERLY FEMALES
MECHANISM OF INJURYDIRECT TRAUMA- SELF DEFENSEINDIRECT TRAUMA- RTA, SPORTS INJURY,
FALL
ASSOCIATED INJURYGALEAZZI FRACTURE/MONTEGGIACOMPARTMENT SYNDROME
SURGICAL ANATOMY
5 BANDS OF INTEROSSEOUS MEMBRANE
DORSAL OBLIQUE BAND
CENTRAL BAND
ACCESSORY BAND
DORSAL OBLIQUE ACCESSORY CORD
PROXIMAL OBLIQUE CORD
SURGICAL ANATOMYIMP STRUCTURES WHILE USING THE
VOLAR HENRY’S APPROACH TO RADIUS- bicep’s tendon to radial styloid
1. BRACHIORADIALIS- RADIAL NERVE2. PRONATOR TERES- MEDIAN NERVE3. FLEXOR CARPI RADIALIS – MEDIAN
NERVE4. PIN- SUPINATOR MUSCLE5. SUPERFICIAL RADIAL NERVE6. RADIAL ARTERY
SURGICAL ANATOMY
SURGICAL ANATOMYIMP STRUCTURES WHILE USING THE
POSTEROLATERAL THOMPSON’S APPROACH-Lateral epicondyle to lister’s tubercle
Superficial radial nerve Cephalic veinExtensor carpii radialis brevisExtensor digitorum communisPronator teresSupinator-PINAbdutor pollicis longus
SURGICAL ANATOMY
SURGICAL ANATOMYIMP STRUCTURES WHILE USING DIRECT
APPROACH TO ULNA- Olecranon to ulna styloid
EXTENSOR CARPI ULNARISFLEXOR CARPI ULNARISDISTALLY PROTECT THE DORSAL BRANCH
OF ULNAR NERVE
SURGICAL ANATOMY
CLASSIFICATIONDESCRIPTIVE1. OPEN VS CLOSED2. LOCATION3. DISPLACEMENT4. ANGULATION5. COMMINUTION, SEGMENTAL,
MULTIFRAGMENTED
OTA CLASSIFICATION
CLINICAL EXAMINATIONPAIN, DEFORMITY, SWELLINGH/O TRAUMAIF PAIN ON PASSIVE STRETCH OF
FINGERS- EVALUATE FURTHER FOR COMPARTMENT SYNDROME
OPEN INJURIES/FOREIGN CONTAMINANTASSESS RADIAL,MEDIAN & ULNAR NERVE
FUNCTIONCHECK RADIAL AND ULNAR PULSES
TREATMENTNON OPERATIVE1. WELL MOULDED CAST WITH GOOD
INTEROSEOUS MOULD IN ISOLATED UNDISPLACED RADIUS OR DISTAL 2/3 ULNA NIGHT STICK INJURY
OPERATIVE1. ORIF WITH 3.5MM DCP2. ORIF WITH LOCKING PLATE3. ORIF WITH BONE GRAFTING4. EXTERNAL FIXATOR IN GUSTILLO TYPE
IIIB/IIIC