ORTHOPEDICSTREATMENT
Closed reduction, long arm or sugar-tong splint, orthopedic follow-up
COMPLICATIONS
Median nerve injury
BARTONFRACTURE
Dorsal or volar rim fractures of the distal radius
DIAGNOSIS
X-ray reveals intra-articular fracture of the volar or dorsal rim of the radius,
which may be comminuted on the AP view.
TREATMENT
Long arm sugar-tong splint, close orthopedic follow-up. Typically these frac-
tures require ORIF, especially if the fracture involves more than 50% of the
articular surface.
COMPLICATIONS
Early arthritis
NIGHTSTICKFRACTURE
This isolated ulnar fracture typically results from a direct blow to the forearm.
DIAGNOSIS
X-ray shows midshaft ulnar fracture. Always examine the proximal radius to
exclude a Monteggia fracture.
TREATMENT
■ Long arm splint for simple nightstick fractures
■ If displaced >50% or angulated >10°, obtain orthopedic referral for possible
ORIF.
ESSEX-LOPRESTIFRACTURE
■ A radial head fracture with dislocation of the distal radial/ulnar joint and
disruption of the interosseous membrane
■ Treat with splint and referral to orthopedics for ORIF.
GALEAZZIFRACTURE
MECHANISM
FOOSH in force pronation or direct blow.
DIAGNOSIS
■ Suspect if patient has pain and swelling to both wrist and elbow
■ X-rays show distal radial shaft fracture and distal radioulnar joint injury
(eg, widening of joint space).