Duke Orthopaedics
Wheeless' Textbook of Orthopaedics

Fractures of the Radius and Ulna Menu

- Types of Radius/Ulna Fractures:
       Both Bone Fractures:
                - Fractures of the Adult Ulna
       - Pediatric Forearm Fractures: 
                - Pediatric Both Bone Forearm Fractures 
                - Pediatric Ulnar Fracture 
                - Green Stick Frx 
                - Distal Ulnar Physeal Fractures 
                - Monteggia's Fracture 
                        - in the child, it is essential to have 3 views of the elbow: (AP, lateral, and oblique) before a Monteggia frx can be ruled out;
                        - this is especially true in proximal ulnar shaft frx;
       Proximal Radial Fractures:
                - radial head frx 
                - pediatric radial neck frx and adult radial neck fracture
       - Distal Radius Fractures:   (Synthes Distal Radius Products)
                - barton's fracture - dorsal
                - barton's fracture - volar
                - chauffeur's fracture
                - colles fracture
                - intra-articular fractures of distal radius 
                - pediatric distal radius fracture 
       - Radial Shaft Fractures: 
                - radial shaft fractures: discussion 
                - both bone fractures 
                - galeazzi's fracture

- Radius Anatomy: 
    - radius is a curved bone with an apex lateral bow with an apex lateral bow; 
    - cylindral in the proximal third, triangular in the middle third, and flat distally ;
    - radius & ulna lie parallel to each other when forearm is supinated;
    - during pronation radius crosses ulna, rotating on axis that passes from capitulum through the distal end of ulna; 
    - proximal radioulnar joint is most stable in supination where the broadest part of the radial head contacts the radial notch of the ulna and the interosseous membrane is taut
    - interosseous membrane:
            - radius and ulna are joined by proximal & distal RU joints & by interosseous membrane, which is directed obliquely downward from radius to ulna;
            - since ulna does not articulate w/ carpi, direction of interosseous membrane is important in transmission of longitudinal forces from radius to ulna; 

- Ulna Anatomy:
    - ulna has a triangular shape throughout, with an apex posterior bow in the proximal third
    - ular side of wrist is supported by TFCC, which articulates w/ both lunate and triquetrium;
    - ulnar attachment of TFC is to base of ulnar styloid & distally to triquetrum w/ volar ulnocarpal ligaments; 

- Function al Anatomy:
    - average range of pronation/supination is 90/90 degrees (50/50 degrees necessary for activities of daily living)
    - middle third deformity has a greater effect on supination, with the distal third affecting pronation to a greater degree 

Ezekiel 30:21 (King James Version)

Son of man, I have broken the arm of Pharaoh king of Egypt; and, lo, it shall not be bound up to be healed, to put a roller to bind it, to make it strong to hold the sword.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Monday, October 28, 2013 8:36 pm

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