Diferencia entre revisiones de «Radia ulna fracture»
Sin resumen de edición |
|||
| Línea 20: | Línea 20: | ||
==Management== | ==Management== | ||
{{General Fracture Management}} | |||
===Specific Management=== | |||
*Rule-out [[compartment syndrome]] | *Rule-out [[compartment syndrome]] | ||
**Often admitted for obs, especially if prolonged reduction | **Often admitted for obs, especially if prolonged reduction | ||
Revisión del 04:31 18 sep 2019
Background
- Requires great amount of force (vehicular trauma, falls from height, direct blow)
- Neurovascular complications are unusual
- One of the most common pediatric fractures
Clinical Features
- Pain/swelling, deformity
- Point tenderness
Differential Diagnosis
Forearm Fracture Types
- Distal radius fractures
- Radius and ulna fracture (both-bone forearm fracture)
- Radial head fracture
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Essex-Lopresti fracture
- Forearm fracture (peds)
Evaluation
- Assess distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
Imaging
- Always consider wrist and elbow films
- Assess for angulation
- AP view: radial styloid and radial tuberosity normally point in opposite directions
- Lateral view: ulnar styloid and coronoid process normally point in opposite directions
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Rule-out compartment syndrome
- Often admitted for obs, especially if prolonged reduction
- ORIF
Disposition
- If splinted and stabilized, can be discharged after consultation with Ortho
- Admit for:
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome