Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Traumatology and orthopaedics
Acute Trauma Management
Trauma in perspective
Principles of Primary Trauma Care
Six phases of Primary Trauma Care
Procedures
Orthopaedic Techniques
Traction
Casts and Splints
Application of external fixation
Diagnostic imaging
Physical therapy
Crania burr holes
Orthopaedic Trauma
Upper extremity injuries
The hand
Fractures of the pelvis and hip
Injuries of the lower extremity
Spine injuries
Fractures in children
Amputations
Complications
War related trauma
General Orthopaedics
Congenital and developmental problems
Bone tumours
Infection
Degenerative conditions
Trauma in Perspective
 

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS





FRACTURES OF THE RADIAL HEAD AND NECK

The radial head is important for pronation and supination of the forearm as well as for flexion and extension motions at the elbow. Fractures are classified by the articular involvement (Figure 18.23).

Figure 18.23
Figure 18.23


Evaluation

Patients have pain and swelling over the lateral aspect of the elbow. Some motion remains in minimally displaced fractures. X-rays confirm the diagnosis.

Treatment

:: Treat fractures with minimal displacement in an arm sling and begin motion when comfortable.
:: ITo reduce displaced fractures of the radial neck:
Place your thumb over the radial head and apply longitudinal traction with a varus stress to the arm
Gently rotate the forearm while applying medial pressure with your thumb to the radial head
Place the arm in a long arm splint
Begin motion out of the splint at 3 weeks.
:: Treat comminuted or displaced intra-articular fractures with early motion. If available, alternatives are surgical stabilization or radial head excision.

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS



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  Kep Points  
In fractures with minimal displacement, treat with closed reduction and a posterior splint and begin motion as soon as comfortable


Treat displaced intra-articular fractures with early motion and consider surgical treatment, if available.