M.E.Müller: Atlas: Fracture 22-A2

Radius/Ulna, Diaphysis,
simple fracture,
radius, ulna intact 0,56% of the total
4,38% of the radius/ulna
17,97% of the segment

100 fractures
32,6% group
81%M, 19%F

108 fractures
35,2% group
79%M, 21%F

99 fractures
32,2% group
75%M, 25%F

Oblique Transverse With dislocation distal radio-ulnar joint (Galeazzi)

These are simple transverse fractures of the diaphysis of the radius. The ulna remains intact. Ref. Manual of Internal Fixation:
232 - 251. 466 - 475.
Surgeon. MS, RO.

In contrast with the ulna, from the surgical standpoint the radius is a difficult bone. Its curved shape, its irregular cross-section with thick cortices and its permanent torsional loading, represent a biomechanical problem that must be taken into consideration for its treatment. All kinds of intramedullary nailings will straighten the curvature of the radius and will not be able to neutralize the torsional loads.

For many years we have treated these fractures with semi-tubular plates and 4.5 mm screws because the edges of the plate would help to block the rotation by engaging into the periosteum, but the screw heads are usually palpable subcutaneously.

With the exception of the proximal radius, we presently use the narrow DCP plates with 3.5 mm screws, that have demonstrated their advantages over the semi-tubular plates. They must be carefully contoured for their adaptation to the diaphyseal curvature and a little more in order to provide compression to the opposite cortex. They must be fixed into 6 cortices of each fragment with 3.5 mm screws. Interfragmentary compression through the screw holes must be performed whenever possible (oblique fractures). The reduction must be anatomical and, faced with small fragmentations, autologous cancellous bone graft (easy to harvest from the olecranon) should certainly be added.

preoperative + 8 months + 8 months

preoperative + 8 months + 8 months

These fractures combine a simple fracture of the radius with an intact ulna and an associated dislocation of the distal radio-ulnar joint. Ref. Manual of Internal Fixation:
232 - 251. 466 - 475.
Surgeon. RO, RO.

They should be treated as a simple fracture of the radius by anatomic reduction and internal fixation with a plate, according to the criteria previously stated. The distal dislocation may require suture of the triangular ligament or the internal fixation of the styloid process of the ulna when it is fractured. The internal fixation of the

styloid process is performed with a Kirschner wire, supported by a tension band wire whenever necessary. The case illustrated in the lower half of the page is a special one because there is an associated dislocation of the proximal fragment of the radius. With dislocation distal radio-ulnar joint (Galeazzi).

preoperative + 3 months + 5 months + 5 months

preoperative preoperative + 1 year 6 months + 1 yeat 6 months




						Radius/Ulna, Diaphysis, simple fracture, radius, ulna intact	0,56% of the total 4,38% of the radius/ulna 17,97% of the segment






These are simple transverse fractures of the diaphysis of the radius. The ulna remains intact.		Ref. Manual of Internal Fixation: 232 - 251. 466 - 475. Surgeon. MS, RO.

In contrast with the ulna, from the surgical standpoint the radius is a difficult bone. Its curved shape, its irregular cross-section with thick cortices and its permanent torsional loading, represent a biomechanical problem that must be taken into consideration for its treatment. All kinds of intramedullary nailings will straighten the curvature of the radius and will not be able to neutralize the torsional loads. For many years we have treated these fractures with semi-tubular plates and 4.5 mm screws because the edges of the plate would help to block the rotation by engaging into the periosteum, but the screw heads are usually palpable subcutaneously.	With the exception of the proximal radius, we presently use the narrow DCP plates with 3.5 mm screws, that have demonstrated their advantages over the semi-tubular plates. They must be carefully contoured for their adaptation to the diaphyseal curvature and a little more in order to provide compression to the opposite cortex. They must be fixed into 6 cortices of each fragment with 3.5 mm screws. Interfragmentary compression through the screw holes must be performed whenever possible (oblique fractures). The reduction must be anatomical and, faced with small fragmentations, autologous cancellous bone graft (easy to harvest from the olecranon) should certainly be added.






These fractures combine a simple fracture of the radius with an intact ulna and an associated dislocation of the distal radio-ulnar joint.		Ref. Manual of Internal Fixation: 232 - 251. 466 - 475. Surgeon. RO, RO.

They should be treated as a simple fracture of the radius by anatomic reduction and internal fixation with a plate, according to the criteria previously stated. The distal dislocation may require suture of the triangular ligament or the internal fixation of the styloid process of the ulna when it is fractured. The internal fixation of the	styloid process is performed with a Kirschner wire, supported by a tension band wire whenever necessary. The case illustrated in the lower half of the page is a special one because there is an associated dislocation of the proximal fragment of the radius. With dislocation distal radio-ulnar joint (Galeazzi).