Orthopedic Care and Consultation
Comminuted fractures are generally as a result of direct trauma to the bone. Following xray is anteroposterior view of the forearm and is revealing fracture ulna. A comminuted fragment is seen in the ulnar fracture.
Comminuted Fracture of Ulna
The patient was a young male and was managed with open reduction and closed reduction
Fracture of ulna with dislocation of radial head is known as Monteggia fracture dislocation [compare with Galeazzi fracture dislocation where radial fracture is accompanied by distal radio ulnar joint instability].
Unlike Galleazzi fracture Monteggia is more common in children but occurs in adults too.
Monteggia Fracture Dislocation
The xray in picture belongs to 35 year old male who sustained this injury after fall from stairs. he had comminuted fracture of ulna and radial head dislocation. Not that radial head dislocation is visible in one view only. Therefore it is necessary to have xrays in both planes.
Moreover, if the elbow region is not visible in the xray, it could have been simply treated as fracture of ulna, only to discover dislocation of the radial head later on. It is important to view one joint above and below the fracture.
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