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Emergency: requires immediate attention
Radius and ulna fracture
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Radius and ulna fracture

Contributors: Christopher Ahlering MD, Robert Lachky MD, Danielle Wilbur MD
Other Resources UpToDate PubMed

Synopsis

Causes / typical injury mechanism:
  • Motor vehicle accident
  • Fall from height with axial loading through the hand into the forearm
  • High-energy direct trauma
Classic history and presentation: History of recent trauma as described above. Presentation will include pain, especially with forearm rotation, wrist movement, or finger movement; swelling; and possible deformity. The incidence of open fractures is very high compared to other fractures.

Prevalence:
  • Age – More common in younger patients.
  • Sex / gender – More common in men than in women.
    Risk factors: Sports (especially contact sports or motor vehicle sports), industrial / construction / similar employment.

    Descriptive classification:
    • Closed versus open
    • Location – Distal, mid-shaft, proximal
    • Comminuted, segmental, multifragmented
    • Displacement
    • Angulation
    • Rotational alignment
    Orthopaedic Trauma Association (OTA) classification:
    • Type A – Simple fracture of ulna (A1), radius (A2), or both bones (A3)
    • Type B – Wedge fracture of ulna (B1), radius (B2), or both bones (B3)
    • Type C – Complex fractures
    Gustilo-Anderson classification for open bone fractures:
    • Type 1 – Wound length < 1 cm; minimal soft tissue damage, contamination, or comminution; periosteum intact; adequate soft tissue coverage; intact vasculature.
    • Type 2 – Wound length < 1 cm; moderate soft tissue damage, contamination, or comminution; periosteum intact; adequate soft tissue coverage; intact vasculature.
    • Type 3a – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; adequate soft tissue coverage; intact vasculature.
    • Type 3b – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; inadequate soft tissue coverage; intact vasculature.
    • Type 3c – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; inadequate soft tissue coverage; arterial damage.

    Codes

    ICD10CM:
    S52.90XA – Unspecified fracture of unspecified forearm, initial encounter for closed fracture
    S52.90XB – Unspecified fracture of unspecified forearm, initial encounter for open fracture type I or II
    S52.90XC – Unspecified fracture of unspecified forearm, initial encounter for open fracture type IIIA, IIIB, or IIIC

    SNOMEDCT:
    75857000 – Fracture of radius and ulna

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    Last Reviewed:10/05/2021
    Last Updated:10/10/2021
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    Emergency: requires immediate attention
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