Radius & Ulna

Radial & Ulnar Named Fractures

• Colles

• Smith

• Chauffeur

• Frykman Classification system

• Galeazzi

• Monteggia

• Remembered by MUGR

  • Monteggia = Ulnar

  • Galeazzi = Radial

Monteggia

• Fracture of ulnar shaft with dislocation of radial head.

• Further classified by Bado system:

  • Class 1: Anterior dislocation of radial head (most common).

  • Class 2: Posterior dislocation of the radial head.

  • Class 3: Lateral or antero-lateral dislocation of the radial head.

  • Class 4: Anterior radial head dislocation as well as proximal third ulnar and radial shaft fractures.

• Radiopaedia link

• Radiopaedia link (Bado)

Galeazzi fractures

• Fracture of distal radius with disruption of the distal radial-ulnar joint.

• Type 1 = Dorsal displacement of the radius

• Type 2 = Volar displacement of the radius

• Notable complications: entrapment of extensor carpi ulnaris tendon or extensor digiti minimi tendon

• Radiopaedia page

Colles Fracture

• Extra Articular fracture of distal radius with dorsal angulation (of the distal fracture fragment).

• Caused by FOOSH with extended wrist and pronated forearm.

• Radiopaedia page

Chauffeur fracture

• Intra-articular fracture of radial styloid process.

• Associated with scaphoid-lunate dissociation.

• Radiopaedia page

Essex-Lopresti Fracture

• Radial head fracture with dislocation of the distal radioulnar joint

Pronator Fat Pad

• linear lucency on volar aspect of wrist, normal finding

• If this lucency is absent = edema = concern for fracture, especially of the radius

Frykman Classification

• Classification of distal radial fractures based on AP appearance.

• Technically includes Colles, Smith, others

• Odd numbers = different types of fractures

• Even numbers = fracture + ulnar styloid fracture

• Type 1: transverse metaphyseal fracture (colles, smith included) (Type 2 + ulnar styloid fracture)

• Type 3: fracture involves the radiocarpal joint (Barton, Chauffeur included) (Type 4 + ulnar styloid fracture)

• Type 5: transverse fracture involves distal radioulnar joint (Type 6 + ulnar styloid fracture)

• Type 7: comminuted fracture with the involvement of both the radiocarpal and radioulnar joints (Type 8 + ulnar styloid fracture)

• Radiopaedia link

References:

Case courtesy of Alexandra Stanislavsky, Radiopaedia.org, rID: 10961 (Galeazzi case)

Case courtesy of Frank Gaillard, Radiopaedia.org, rID: 8012 (Monteggia case)

Case courtesy of Frank Gaillard, Radiopaedia.org, rID: 12382 (Colles case)

Case courtesy of Henry Knipe, Radiopaedia.org, rID: 46624 (Chauffeur case)