37. Fracture of the axillary bones

Fractures of the Forearm

• ① Fracture of the coronoid process of the ulna
• ② Fracture of the head and neck of the radius
• ③ Painful pronation (in children)
• ④ Fracture of the diaphyses of the forearm bones
• ⑤ Isolated fracture of the radius
• ⑥ Isolated fracture of the ulna
• ⑦ Luxation-fracture of the ulna (Monteggi)
• ⑧ Galeazzi fracture-luxation (fracture of the radius with dislocation of the distal radioulnar joint)

① Fracture of the coronoid process of the ulna

↪ Rare intra articular fracture of an extended elbow

CLINICAL MANIFESTATION

• Edema
• Hemarthrosis
• Restricted movements
• Upon palpation: Local pain

DIAGNOSIS: Xray: Lateral view – visualizing coronoid process, fracture line

Classification (Regan and Morrey Classification):

1. Type I – Small, avulsion fracture of the tip of the coronoid.
2. Type II – Fracture involving <50% of the coronoid process.
3. Type III – Fracture involving >50% of the coronoid, often associated with instability.

TREATMENT:

1. Non dislocated fractures

• Immobilization for period of 3 weeks with arm in flexion in the ulnar joint (elbow)

2. Dislocated fractures -

• Larger fragment: Osteosynthesis
• Smaller fragment: Extirpation - excision of the fragment