Special fracture forms
Galeazzi fracture is the combination of fracture of the radial shaft, dislocation of the ulna, and rupture of the interosseous membrane – the membrane between the radius and the ulna. It is usually preceded by a fall on the extended arm. Since there are several affected bone compartments, a plaster cast alone is not sufficient.
In most cases, osteosynthesis is attempted by means of plates or screws, so that the separated bones are artificially fixed together again. A Monteggia fracture is a fracture of the proximal ulna, with dislocation of the radial head from its socket. In this case, the radial head must first be reduced before a supply of bone can be initiated.
A typical forearm fracture is also the so-called green wood fracture. This is a flexural fracture of the bone in which, similar to bending a damp or green branch, the bone core is broken, but the bark (or periosteum in humans) is preserved. If the degree of bending is low, the restoration is then conservatively made with plaster; if the angle of axial deviation is higher, the compressed side is also initially broken before the restoration can be made.
Symptoms
In the case of a fracture, a distinction is made between safe and unsafe fracture signs. Unsafe fracture signs are: Safe fracture signs are: Patients also often hear the bone breaking, at the moment of fracture a cracking sound can be heard, like when you break a piece of wood. Since the periosteum is permeated with many nerve fibers, there is always a lot of pain in the beginning.
These can subside when the arm is no longer moved. Pain generally only occurs when the periosteum is touched and stretched. A broken arm that is not moved does not necessarily cause pain.
It should also be remembered that immediately after the trauma occurs, adrenaline is released which modulates and reduces the pain. One is literally “in shock“.A good example of how strong this “suppression reaction” can be is provided by an incident in the army: Since the adrenaline level in combat is too high, soldiers examine each other, and not themselves, for wounds in cases of suspicion. In this way, they try to rule out that any injuries to their own bodies are simply overlooked.
The shock reaction, in which relative painlessness occurs, can last up to an hour. During this time an appropriate pain medication should already have been initiated by a doctor.
- Pain
- Swelling
- Bruise
- Restricted movement
- Overheating
- Visible axial malposition of the bone
- “Crepitational noises” (crunching noises when the bone moves)
- Visible bone fragments
- Abnormal mobility
