Radius and Ulnar Shaft Fracture 813.23

Stryker / Howmedica

synonyms: Both Bone Forearm fracture, Fx

Forearm Fx ICD-9

  • 813.23(fracture of the radius and ulna; closed)
  • 813.33(fracture of the radius and ulna; open)

Forearm Fx Etiology / Epidemiology / Natural History

Forearm Fx Anatomy

  • Bicipital tuberosity should be directly opposite (180 degees) to radial styloid
  • Rotational forces usually cause fx at different levels
  • Apex volar -pronation
  • Apex dorsal - suppination
  • Remodeling 0.9 degrees per month, 10 degrees per year.
  • Loss of forearm rotation in not seen untill a minimum of 30° of rotational maluion exists. (Kasten P, JBJS JOT 2003;17:57)
  • See also Forearm anatomy.

Forearm Fx Clinical Evaluation

Forearm Fx Xray / Diagnositc Tests

  • A/P and Lateralof radius/ulna to include elbow and wrist
  • Separate views of wrist and elbow if indicated
  • Template before case

Forearm Fx Classification / Treatment

  • Non-displaced: must ensure anatomic bow of the radius is maintained. RX=Short-arm cast.
  • Displaced: virtually any displacement in a diaphyseal forearm fracture in an adult is an indication for ORIF. Early operative treatment improves outcomes.
  • Pediatric forearm fractures
  • Open Forearm Fx: irrigation and debridement with immediate plate fixation (Moed BR, JBJS 68A:1008;1986). Consider external fixation with delayed ORIF if severly contaminated.
  • ORIF (Chapman MW, JBJS 71A:159;1989)
  • AO Classification with approaches: AO Classification

Forearm Fx Associated Injuries / Differential Diagnosis

Forearm Fx Complications

Forearm Fx Follow-up Care

  • Post-op: Volar plaster splint with sling. NWB. Active elbow and finger ROM.
  • 7-10 Days: Wound check, Place in funtional brace (interosseous mold). Begin active pronation/supination. Continue active elbow and finger ROM. Activity restrictions. Use for arm for light ADLS only. NWB.
  • 6 Weeks: Gradually resume normal activites provided bony union is evident on xrays.
  • 3 Months: Consider bone stimulatorif union is not evident on xray.
  • 6 Months: return to sports / full activities.
  • 1Yr: Follow-up xrays, assess outcomes.

Forearm Fx Review References

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