The Hip book
Home » Trauma And Fractures Menu » Radial Shaft Fractures: Discussion

Radial Shaft Fractures: Discussion

- See:
      - Anterior Approach to the Radial Shaft: (Henry)
      - Blount Fracture: Both Bone Forearm Fracture
      - Boyd Surgical Approach
      - Distal 1/3 of the Radius through an Anterolateral Incision
      - Dorsal Approach (Thompson)
      - Galeazzi's Fracture
      - Proximal 1/3 of the Radius thru the Anterolateral Incision
- Approach to the Radius:
      - when the fracture is in distal half of the bone, expose it through anterior approach of Henry & apply plate to volar surface;
             - this defies the principle of applying plate to tension side (dorsal surface);
             - since the soft tissue coverage on the volar surface is better and bone contour is flat, it is easier to apply plate on volar surface;
       - when frx is in proximal half, expose it thru dorsal Thompson approach, and apply the plate to the dorsal surface;
              - radial nerve is less likely to be injured thru this approach than through the anterior approach;
              - plate on the dorsal aspect of the proximal radius is also less likely to produce mechanical block to pronation than if applied to the anterior surface;
      - when frx is in the middle third either approach may be used;
             - consider applying the plate to side (anterior vs. posterior) which has greater comminution;
- Complications: Cadaveric studies (Mathews, 1982)
    - residual angulation of 10 deg in mid shaft radial frxs or ulna or both will not limit forearm rotation anatomically
    - loss of rotation is expected w/ residual angles of > 20 deg;
    - degree of rotatory deformity parallels loss of pronation & supination;
    - supination losses for mid 1/3 > than for distal 1/3 deformities
    - compartment syndrome;
    - synostosis:
           - uncommon but more common in crush injuries

Growth plate activity in the upper extremity.

Congenital proximal radio-ulnar synostosis. Natural history and functional assessment.

Late results of excision of the radial head for an isolated closed fracture.

Results of delayed excision of the radial head after fracture.

Intra-articular fractures of the distal end of the radius in young adults.

Angulated radial neck fractures in children. A prospective study of percutaneous reduction.