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Distal Radius Fracture

Epidemiology

 

2 groups

 

1.  Elderly

- low velocity injury

- osteoporotic

- need to start bisphosphonates

 

2.  Young patients

- high velocity injury

 

Anatomy

 

Distal Radius Angles

- radial volar tilt 11°

- radial inclination  22°

- radius is 11 mm longer than ulna 

- ulna variance 2mm positive on average

 

Olecranon Fracture

Definition

 

Intra-articular proximal ulna fracture

 

Anatomy

 

Articulates with trochlea

- may have a central bare area

 

Triceps insertion

- via broad aponeurosis which blends with anconeus and CEO

 

Management

 

Non operative Management

 

Undisplaced fracture

- need to ensure triceps mechanism is intact

Forearm Fractures

Ossification

 

Primary

- 8 / 52 gestation radius & ulna

 

Secondary

- distal radius age 1

- distal ulna age 5

 

Non Operative Management

 

Unacceptable Position

 

< 10:  > 15o malalignment

> 10:  > 10o malalignment

 

Postreduction Positionin / Rule of Thirds 

 

Femoral Fractures

Aetiology

Paediatric femoral fracture

 

Varies per age group

 

Trauma

- 60%

 

Non Accidental Injury

- 15 - 30%

- suspect if non walker / < 1 year

- walking status single best indicator of risk

- paediatric team to investigate

- history taking from parent

- consider metabolic investigations

 

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