* In children, the treatment is an orthopedic reduction followed by immobilization.
* The immobilization is maintained for 4 to 6 weeks depending on the child's age and the development of bone healing.
* In adults the treatment of choice is surgical. Orthopedic treatment is reserved for fractures without displacement, followed by immobilization for 6 to 8 weeks.
* Prolonged immobilization can lead to irreversible side rigidities.
* The delayed union and nonunion are also more common in orthopedic treatments in the adult surgery.
Complications of fractures of the forearm
* The most common is the limitation of supination if you have not achieved an anatomic reduction.
* The fracture.
* Compartment syndrome.
* Delay of consolidation and pseudarthrosis.
* Street vicious and traumatic radioulnar synostosis that severely limit supination.
Radius and ulna FRACTURES
* Fractures of the proximal.
o Both the fracture of the radial head and olecranon usually require surgical correction, since they are intra-articular fractures.
o olecranon fractures should always seek the possible dislocation of radial head (Monteggia fracture dislocation).
oThe comminuted fractures of the radial head can progress to necrosis of the fragments or blockage of the mobility of the elbow and forearm supination.
* Diaphyseal fractures
Whether you isolated both bones of the forearm or not, this usually requires fixation, where it is better to use the synthesis plates.
o If the fractures are open, we may take the option of intramedullary synthesis.
o Fractures in this location may be complicated by the development of:
+ A compartment syndrome, which should be treated by fasciotomy.
+ Another complication is nonunion, which was previously treated with internal fixation and bone grafting.
The progressive Reeducation of the wrist and the elbow.
* Fractures of the distal
These fractures are very common in both adults, children and adolescents.
o The treatment is basically the reduction and immobilization with plaster cast.
In unstable fractures or joint involvement an intervention would be indicated.
o The distal radius fracture may be associated with fractures of the ulna at the same level as the dislocation of the distal ulna (Galeazzi fracture-dislocation), or what is more common in Colles fractures (fracture of the distal epiphysis the radius of the adult), fracture of the ulnar styloid process .
Every time there is a broken bone in the forearm, there may be another fracture or dislocation of radiolunar joints either proximal or distal.
Isolated fractures of the ulna or radius are rather uncommon.
o The production mechanism of these fractures is generally indirect, generally through the fall with the palm of the hand.
o The direct mechanism can produce a fracture of only one of the two forearm bones.
Forearm fractures in adults are usually displaced.
o The movement consists of the segments straddling the radius and ulna.
• This is a break at the end of the main bone of the forearm (radius) or the two lower arm bones (radius and ulna). During a Colles fracture, the position of the handmust be held back and outwardly with respect to the forearm.
• Transverse wrist fracture
• Typically, this injury is the result of trauma from a fall when a person attempts to break into your hands and arms.
• Wrist fractures are common in children and the elderly.
• The bones of children are likely to fold because they are still growing and therefore are somewhat weak.
• Older people with Colles fractures:
• Not usually regain full mobility of the wrist joint and carpal tunnel syndrome may be a late complication of this injury.
• Injuries of the ligaments or the joint surface of the wrist can cause chronic pain.
• Carpal Tunnel Syndrome
• post-traumatic arthritis
• Reflex Sympathetic Dystrophy
• Call cycle
• Lock in supination, especially when surgery was made
• Immobilization splint or sling
• Surgery to fix it internally or it may require a plate with screws.
• It is especially important to avoid making a reflex to avoid dystrophy for an active and painless rehabilitation .