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    Case Report: Fracture of Distal of Right Radius Fracture of Styloid of Right Ulna

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    -'Rhya Rhyemma James Potter'-
    1. A 42-year-old female presented to the hospital with right wrist pain after a traffic accident. Physical examination revealed deformity, edema, hematoma, and tenderness of the right forearm. X-rays showed a closed fracture of the distal radius and styloid process of the right ulna. 2. She was diagnosed with closed fractures of the distal right radius and right ulnar styloid process. Treatment included IV fluids, analgesics, application of a volar slab below the elbow, and arm sling immobilization. 3. Fractures of the distal radius are common injuries, often resulting from falls on an outstretched hand. Treatment may involve casting, percutaneous pinning

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    Case Report: Fracture of Distal of Right Radius Fracture of Styloid of Right Ulna

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    -'Rhya Rhyemma James Potter'-
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    1. A 42-year-old female presented to the hospital with right wrist pain after a traffic accident. Physical examination revealed deformity, edema, hematoma, and tenderness of the right forearm. X-rays showed a closed fracture of the distal radius and styloid process of the right ulna. 2. She was diagnosed with closed fractures of the distal right radius and right ulnar styloid process. Treatment included IV fluids, analgesics, application of a volar slab below the elbow, and arm sling immobilization. 3. Fractures of the distal radius are common injuries, often resulting from falls on an outstretched hand. Treatment may involve casting, percutaneous pinning

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    1. A 42-year-old female presented to the hospital with right wrist pain after a traffic accident. Physical examination revealed deformity, edema, hematoma, and tenderness of the right forearm. X-rays showed a closed fracture of the distal radius and styloid process of the right ulna. 2. She was diagnosed with closed fractures of the distal right radius and right ulnar styloid process. Treatment included IV fluids, analgesics, application of a volar slab below the elbow, and arm sling immobilization. 3. Fractures of the distal radius are common injuries, often resulting from falls on an outstretched hand. Treatment may involve casting, percutaneous pinning

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    20 views23 pages

    Case Report: Fracture of Distal of Right Radius Fracture of Styloid of Right Ulna

    Uploaded by

    -'Rhya Rhyemma James Potter'-
    1. A 42-year-old female presented to the hospital with right wrist pain after a traffic accident. Physical examination revealed deformity, edema, hematoma, and tenderness of the right forearm. X-rays showed a closed fracture of the distal radius and styloid process of the right ulna. 2. She was diagnosed with closed fractures of the distal right radius and right ulnar styloid process. Treatment included IV fluids, analgesics, application of a volar slab below the elbow, and arm sling immobilization. 3. Fractures of the distal radius are common injuries, often resulting from falls on an outstretched hand. Treatment may involve casting, percutaneous pinning

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    © All Rights Reserved
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    of 23

    CASE REPORT:

    FRACTURE OF DISTAL OF RIGHT RADIUS


    FRACTURE OF STYLOID OF RIGHT ULNA
    BY:
    NOR FARHANA BT OMAR
    C 111 09 870

    ADVISOR:
    DR. WIRA/DR.PADLAN

    SUPERVISOR:
    dr. ZULFAN OKTASATRIA Sp.OT
    PATIENT IDENTITY
    Name • Harianti

    Age • 42 years old

    Sex • Female

    Date of • 3rd March 2015


    admission

    Medical
    record • 710663
    HISTORY TAKING
    Chief complain

    Pain at the wrist of the right hand

    History of illness
    suffered since 1 hour before admitted to Wahidin
    hospital due to traffic accident.

    Mechanisme of trauma
    Patient drove the motorcycle but suddenly fall by herself to her right
    side. . The patient is a secretary and her right hand was a dominant
    hand.
    History of unconsciousness (-), nausea (-), vomited (-)
    PRIMARY SURVEY
    Airwa • patent, obstruction (-)
    y

    Breat • RR= 18x/minute, spontaneous, thoracoabdominal type


    hing
    • BP= 100/70 mmHg, PR = 88x/minute regular, strong
    Circul
    ation
    • GCS 15 (E4M6V5), pupil isokor
    Disabi
    • ϕ 2.5mm/ 2.5 mm, light reflex +/+
    lity
    Enviro • T= 36.7oC (axillar)
    nmen
    t
    SECONDARY SURVEY
    Inspection Palpation ROM NVD

    • Deformities • Tenderness (+) • Active and • Sensibility is


    (+), hematoma passive good, pulse of
    (+), edema (+), motion at radialis artery
    wound (-) elbow joint palpated,
    are within capillary refill
    normal limit time <2“
    and active and
    passive
    motion at the
    wrist joint are
    limited due to
    pain
    sensation.
    Clinical Finding
    Regio Antebrachii Sinistra
     Anterior view

     Medial view

     Lateral view
    LABORATORY FINDINGS
    RBC 4.75

    HGB 11.9

    HCT 39.0

    PLT 347

    WBC 17.8

    BT 3’00”

    CT 7’30”

    HBsAG Non-reactive
    RADIOLOGY FINDINGS

    X-ray Antebrachi AP/Lateral view of the right hand


    SUMMARY
    • Female, 42 years old was admitted to RSWS with pain at
    the wrist right hand. Suffered since 1 hour before admitted
    due to traffic acident.
    • From physical examination, on the right forearm region,
    there are deformity, edema, hematoma, and tenderness.
    ROM, Active and passive motion at elbow joint are within
    the normal limit and active and passive motion at wrist
    joint are limited due to pain sensation. NVD, Sensibility is
    good, pulse of radialis artery palpated, capillary refill time
    <2“
    • Radiographic Antebrachii Dextra AP/Lateral showed
    fracture 1/3 distal os radius et ulna dextra
    • From laboratory results, there are leucosytosis.
    DIAGNOSIS
    • Closed fracture distal of the right radius
    • Closed fracture processus styloid of the right
    ulna
    MANAGEMENT
    • IVFD
    • Analgesic
    • Apply volar slab below elbow at right upper
    extremity and arm sling
    DISCUSSION

    CLOSED FRACTURE DISTAL RADIUS


    CLOSED FRACTURE PROCESSUS
    STYLOID OF ULNA
    ANATOMI

    •Thompson, Jon C. Netters Concise Atlas of Orthopedics Anatomy, 1st edition. Learning System LLC, A
    Subsidiary of Elsevier Inc. 2001; page 89
    •Thompson, Jon C. Netters Concise Atlas of Orthopedics Anatomy, 1st edition. Learning System LLC, A
    Subsidiary of Elsevier Inc. 2001; page 106
    •Thompson, Jon C. Netters Concise Atlas of Orthopedics Anatomy, 1st edition. Learning System LLC, A Subsidiary of
    Elsevier Inc. 2001; page 108
    EPIDEMIOLOGY

    • 17% of all ER visits


    Frequency • Race: No racial preferences have been reported

    • Bimodal age distribution:


    • Peaks at ages 5-14 years and at ages 60-69 years.
    Age • Elderly patients extra-articular, metaphyseal
    • Young patients intra-articular fractures with joint surface
    displacement.

    • In older postmenopausal women, female-to-male


    Gender ratio 4:1
    • but In adolescent boys and girls, the ratio is 3:1
    MECHANISM OF INJURY
    Mechanism depends on the position of the wrist, the magnitude and direction
    of the force, and the physical properties of the bone

    A fall on the outstretched hand with the wrist in 40 degree to 90 degree of


    dorsiflexion produces a distal radius fracture with dorsal replacement

    The lunate can exert a compressive force on the distal radius, producing a so
    called die- punch fracture

    The ulnar styloid fracture component of the colles fracture result from a force
    transmitted through an intact triangular fibrocartilage
    DIAGNOSIS
    History of trauma

    Clinical examination: look for other injury

    Injury should evaluated: open/closed, degree of soft tissue injury, neuravascular


    injury-median nerve injury common, tendon injury

    Imaging: forearm/ wrist PA, Lat, oblique, CT scan -intraarticular


    RADIOGRAFIC ASSESMENT
    • radial inclination is measured
    on PA view (normal angle 15-
    25 degree)
    • volar tilt
    • radial length
    • Any intra-articular gap or
    step
    FRYKMAN Classification of distal radius
    fracture
    OPTIONS FOR TREATMENT
    CASTING
    • Long arm vs short arm
    • Sugar –tong splint
    EXTERNAL FIXATION
    • Joint spanning
    • Non bridging

    PERCUTANEOUS PIN

    INTERNAL FIXATION
    • Dorsal plating
    • Volar plating combined dorsal/volar plating
    • Focal (fracture specific) plating
    TREATMENT GOAL

    Preserve hand Realign normal


    Promote bone
    and wrist osseous
    healing
    function anatomy

    Allow early
    avoid
    finger, and
    complications
    elbow ROM
    THANK YOU

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