Radiology #3 Radial & Ulnar Bone Fractures

Why hello! After a lovely lecture today about radial and ulnar bone (the two bones that make up your forearm) fractures in my diagnostic imaging class, and viewing an elbow series today in radiology conference, I've decided to post about four of the different fractures that occur and their mechanism of injury. The top radiograph is normal anatomy of the wrist, so that you may understand or more readily observe the fracture. The thicker of the two bones is radius, and the thinner of the two is the ulna, notice on the lateral projection (the xray on the right, the two bones are super imposed over each other, or line up). The first type of fracture is called a Colles' fracture. A Colles' fracture is a fracture of the distal (more towards the fingers) radius where the fracture fragment is displaced posteriorly. Colles' fractures are also classified as osteoporotic fractures and are usually the first place where a fracture appears in post-menopausal women. This type of fracture usually occurs when someone has fallen on (an) out stretched hand (FOOSH). The second type of fracture is a Smith's fracture aka reverse Colles' fracture where the fracture fragment is displaced anteriorly (palm side of the hand). This type occurs when someone doesn't have time to extend their wrist when falling, usually occurs in elderly patients whose mental capacity is fading. The third type of fracture is called a Galeazzi fracture. It's a fracture of the distal radius that is accompanied by an ulnar dislocation, this also often occurs from a FOOSH type injury, where the fracture radius is shortened. Notice that the "fracture fragment" remains with the carpal bones and the hand. Often radiologists will use the thumb as an indicator as to which direction the fracture will displace. The last type of fracture I'm going to discuss tonight is a Monteggia fracture, it's almost the opposite of a Galeazzi fracture. A monteggia fracture is fracture of the proximal ulna (towards the elbow) with a dislocation of the radius. The more serious of the last two types of fractures that I've listed are the dislocations because soft tissue healing is a longer, less developed process than bone healing. Some of the fractures, depending on the severity are surgical cases where screws, plates, bars, etc will be inserted and then casted. Can you say bad day?