Distal forearm Distal forearm fractures and fractures and dislocationsdislocations

Dr. Ihab RassemDr. Ihab RassemLecturer of RadiologyLecturer of RadiologyAin Shams University Ain Shams University

Cairo, Egypt Cairo, Egypt

RadiographyRadiography

PA & Lateral are sufficient in most PA & Lateral are sufficient in most cases cases

Radiographic Radiographic anatomyanatomy

Neutral Ulnar varianceNeutral Ulnar variance

Negative Positive Negative Positive

Ulnar slant of articular surface of Ulnar slant of articular surface of radiusradius

Measured on PA viewMeasured on PA view

Palmar inclination anglePalmar inclination angleMeasure on Lateral viewMeasure on Lateral view

Fracture typesFracture types

1.1. Colles FractureColles Fracture

2.2. Smith Fracture Smith Fracture

3.3. Barton fracture Barton fracture

4.4. Hutchinson fractureHutchinson fracture

5.5. Essex-Lopresti fracture dislocationEssex-Lopresti fracture dislocation

6.6. Galeazzi fracture dislocationGaleazzi fracture dislocation

Colles FractureColles Fracture

Most frequently encountered injury to the Most frequently encountered injury to the distal forearm.distal forearm.

Fall on the outstretched hand with forearm Fall on the outstretched hand with forearm pronated in dorsiflexion. pronated in dorsiflexion.

Age usually above 50y; F>M.Age usually above 50y; F>M. Extraarticular 2-3 cm away from articular Extraarticular 2-3 cm away from articular

surface of radius.surface of radius. Associated # of ulnar styloid processAssociated # of ulnar styloid process

Smith FractureSmith Fracture

Fracture of the distal radius with Fracture of the distal radius with volar displacement and angulation of volar displacement and angulation of the distal fragment the distal fragment

Results from a fall on the back of the Results from a fall on the back of the hand or a direct blow to the dorsum hand or a direct blow to the dorsum of the hand.of the hand.

Often referred to as a reverse Colles Often referred to as a reverse Colles fracture. fracture.

Smith FractureSmith Fracture

Barton FractureBarton Fracture

Fracture of dorsal margin of the Fracture of dorsal margin of the distal radius extending into the distal radius extending into the radiocarpal articulation.radiocarpal articulation.

Reverse (or volar) Barton fracture: Reverse (or volar) Barton fracture: when it involves the volar aspect of when it involves the volar aspect of distal radiusdistal radius

Barton FractureBarton Fracture

Reverse BartonReverse Barton

Hutchinson FractureHutchinson Fracture

Also known as chauffeur's fracture.Also known as chauffeur's fracture. Involves the lateral margin of the Involves the lateral margin of the

distal radius, extending through the distal radius, extending through the radial styloid process into the radial styloid process into the radiocarpal articulation .radiocarpal articulation .

Best seen in PA viewBest seen in PA view

Hutchinson FractureHutchinson Fracture

Essex-Lopresti Fracture-Essex-Lopresti Fracture-DislocationDislocation

Complex type injury which comprisesComplex type injury which comprises

1.1. Comminuted fracture of the radial Comminuted fracture of the radial head and neck +/- distal extension.head and neck +/- distal extension.

2.2. Tear of the interosseous membrane.Tear of the interosseous membrane.

3.3. Dislocation in the distal radioulnar Dislocation in the distal radioulnar joint. joint.

Galeazzi Fracture–Galeazzi Fracture–DislocationDislocation

This injury type comprises:-This injury type comprises:-

1.1. Fracture of the distal third of the Fracture of the distal third of the radius, radius,

2.2. Dislocation in the distal radioulnar Dislocation in the distal radioulnar joint. joint.

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