Makindo Medical Notes

Introduction

Forearm fractures are common injuries and can involve both the radius and ulna, as the forearm functions as a ring structure. Disruption in one part of the forearm is often associated with injury at another location. Two significant eponymous fractures of the forearm are Monteggia and Galeazzi fractures.

Clinical Findings

• Deformity of the forearm
• Reduction in active range of elbow and/or wrist movement
• Assess and document distal neurological function
• Assess and document distal vascular function

X-Ray Findings

• Request RADIUS and ULNA X-ray.
• If a Monteggia fracture/dislocation is suspected, request a dedicated lateral elbow view.

Common Eponymous Fractures

Fracture Name	X-Ray Findings	Initial Management	Follow-Up
Monteggia	Fracture of the ulnar shaft with dislocation of the proximal radial-ulnar joint (abnormal radial-capitellar line).	Adequate analgesia, long-arm backslab, and broad-arm sling.	Refer to on-call orthopaedics.
Galeazzi	Fracture of the radius with dislocation of the distal radial-ulnar joint.	Adequate analgesia, long-arm backslab, and broad-arm sling.	Refer to on-call orthopaedics.
Isolated Ulna Shaft Fracture	Fracture isolated to the ulna shaft, often from direct trauma (e.g., defensive injury).	Adequate analgesia, long-arm backslab, and broad-arm sling.	Refer to on-call orthopaedics.

Management Principles

• Ensure adequate analgesia.
• Immobilise using a long-arm backslab.
• Apply a broad-arm sling for comfort.
• Refer to on-call orthopaedics for definitive management.

Complications

• Non-union or malunion of fractures
• Loss of forearm rotation or joint mobility
• Neurovascular compromise