Distal ARadius shaft Fractures

Question 1

What are the anatomical structures to be screened when looking at an image of distal forearm fractures?

Answer 1

*The distal radio ulnar joint
* The scaphoid and lunate fossa.
* The sigmoid notch
* The radial and ulnar styloids
* The triangular fibrous cartilage
* The displacing force of the brachioradialis

Question 2

What are the common types of distal radius fractures ?

Answer 2

*Cole’s fracture
* Smith’s fracture
* Die- punch fracture
* Chauffeur fracture
* Barton’s fracture

Question 3

What is the presentation of Cole’s fracture?

Answer 3

It is a low energy extra articular fracture. It presents with dinner fork deformity due to the Dorsal displacement of the distal fragment of the radius.

Question 4

What percentage of Colle’s fracture causes TFCC tear ?

Answer 4

50%

Question 5

What type of Colle’s fracture has poor prognosis?

Answer 5

The Colle’s fractures that extended to the DRUJ.

Question 6

What is the surgical indication for surgical management of Colle’s fracture?

Answer 6

If there is at least 50% dorsal comminution relative to the bone cortex.

Question 7

What is a Smith’s fracture?

Answer 7

It is a reverse Colle’s fracture with palmar displacement of the distal bone fragment.
There are three types of smith fractures.

Question 8

What is type 01 Smith’s fracture?

Answer 8

It is a transverse fracture,the most common type.

Question 9

What is type 02 Smith’s fracture?

Answer 9

It is the fracture with an oblique lesion which causes the proximal fracture segments to invaginate the Dorsal articular surface.

Question 10

What is type 03 Smith’s fracture?

Answer 10

In this the proximal fracture segment enters the radiocarpal joint causing dislocation of proximal carpal bones. This is similar to the volar Barton’s fracture

Question 11

What is the management of Smith’s fracture?

Answer 11

Type 01 if not displaced significantly conservative reduction and immobilization. All other types with significant displacement are treated with ORIF plating or K wire.

Question 12

What is Die- punch fracture?

Answer 12

It is an intra-articular depression fracture of the lunate fossa due to the axial load transmission.

Question 13

What are Barton’s fractures ?

Answer 13

These are intra-articular radiocarpal joint dislocation fractures with either volar or dorsal displacements. These are treated surgically with Volar plates and ORIF for dorsal type.

Question 14

What is Chauffeur’s fracture?

Answer 14

It is the fracture of the radial styloids process with scapho-lunate dislocation.

Question 15

What is the imaging view for scapho-lunate dislocation in Chauffeur’s fracture?

Answer 15

Supination view.

Question 16

What is Galeazzi’s fracture?

Answer 16

Galeazzi fracture is a fracture of the middle to distal third of the radius associated with dislocation or subluxation of the distal radioulnar joint (DRUJ).

Question 17

What is the management of Galeazzi’s fracture

Answer 17

It is usually treated with closed reduction and splinting. However, if the DRUJ instability and or displacement is significant ORIF.

Question 18

What is Montagia fracture?

Answer 18

It is the fracture of the proximal third of the ulna with displacement of the radial head. Place it immediately in a sugar tong splint and refer to the orthopedician for closed reduction.