Įvaluation of the extremity's neurovascular status is imperative. There may also be an association of ulnar styloid base fractures. In addition to the volar displacement of the distal fragment, disruption of the distal radioulnar joint (DRUJ) and the triangular fibrocartilage complex (TFCC) often occurs. ![]() One of Smith’s first diagnostic criteria was a deformed wrist with swelling visible on the volar side and the prominence of the ulna along the dorsum of the wrist. Also, present on the exam are swelling, pain, and decreased ROM. The physical exam may reveal a deformity of the distal forearm, but the direction of angulation- dorsal (Colles) or volar (Smith) is difficult to discern on visualization. Data appears to support a direct correlation between low-energy trauma-induced distal radius fracture and decreased bone mineral density. Between the ages of 64 to 94, women are six times more likely than men to sustain this type of fracture. ![]() In the elderly population, distal radial fractures are the second most common fracture, second only to hip fractures. Almost all distal radius fractures arise in children sustaining high-energy falls and osteoporotic seniors who suffer low-energy falls. The highest incidence of Smith's fractures is in young males and elderly females. However, Smith fractures make up approximately 5% of all radial and ulnar fractures combined. Distal radial fractures are the second most common fracture in the elderly. With over 600000 cases annually in the United States alone, distal radial fractures account for more than 16% of all adult fractures and 75% of forearm fractures. Monteggia sounds close to mountain and since a mountain is high up, Monteggia is more proximal (higher) than Galeazzi.The distal radius is the most common fracture site in the upper extremity. Glasgow Rangers: Galeazzi / radial fracture Two British football (soccer) teams, with devoted followings: M: Monteggia U: ulna fracture R: radial head dislocation G: Galeazzi R: radius fracture U: ulna dislocation GRUesome MURder assists remembering which bone is firstly fractured and then secondly which is dislocated: Galeazzi involves fracture of the radius with distal radioulnar dislocation Monteggia involves fracture of the ulna with proximal radial dislocation GRIMUS helps to remember which forearm bone is fractured and whether the distal ("inferior") or proximal ("superior") part of the other forearm bone is dislocated. Essex-Lopresti starts with E for elbow indicating that it involves the radial head or neck wheras Galeazzi involves the radial diaphysis. Galeazzi and Essex-Lopresti fractures are the inverse both involve the radius with dislocation of the distal radioulnar joint. ![]() A being the first letter of the alphabet, there is dislocation of the proximal radioulnar joint. It is the only one of the eponymous forearm fracture-dislocations to involve the ulna. Monteggi A rhymes with ULN A (emphasis "ah" sound). It is useful to note that it is the head of the non-fractured bone that is dislocated.Īn alternative to the various mnemonics is the following simple rule set for eponymous fracture-dislocations of the forearm: There are several mnemonics for the difference between a Galeazzi and a Monteggia fracture-dislocation:
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