Isolated radius fracture (proximal)

Background

Left arm, anterior view of radius and ulna.

Left arm, posterior view of radius and ulna.

• Rare
• When occur, most are displaced
• Compartment syndrome is rare
• Occur from direct blow to forearm or FOOSH

Clinical Features

• Pain/swelling, deformity
• Point tenderness

Differential Diagnosis

Forearm Fracture Types

• Distal radius fractures
  • Colles' fracture
  • Smith fracture
  • Barton fracture
  • Radial styloid fracture
  • Distal radioulnar joint disruption
• Radia ulna fracture
• Isolated radius fracture (proximal)
• Isolated ulna fracture (i.e. nightstick)
• Monteggia fracture-dislocation
• Galeazzi fracture-dislocation
• Forearm fracture (peds)

Evaluation

• Require full evaluation of DRUJ stability
• Assess distal pulse, motor, and sensation
• Forearm x-ray 2-view

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

Immobilization

• ED: Splint

Disposition

• Outpatient with orthopedic followup

Definitive Specialty Care

• Non-displaced: cast immobilization
• Displaced: Internal fixation

See Also

• Forearm Fracture