Orthopaedic Quiz 3

A 55yo female presents to the ED with the following x-ray following a fall.

Frontal Case Source
Lateral

Lateral

Question 1
What type of fracture(s) is seen on this x-ray?

Hover over the icon for the answer:
Colles fracture (distal radius fracture with dorsal angulation of fractured bone) + transverse fracture through ulnar styloid process

Question 2
What is the most common mechanism of injury for this type of fracture?

Answer:
Fall on outstretched hand (FOOSH) with forearm pronated and wrist dorsiflexed.

Question 3
What is the difference between the above type of fracture and a Smith’s fracture?

Answer:
Smith's fracture is a transverse fracture of the distal radius with PALMAR angulation of the fractured bone. It is caused by a fall on a FLEXED wrist or a blow to the dorsal forearm. It is much less common than a Colle's fracture.

A young male presents to the ED following a fall whilst playing sports.

Frontal Case Source
Lateral

Lateral

Question 4
What type of fracture(s) is seen in this x-ray?

Answer:
Galeazzi fracture: radius fracture with distal radioulnar dislocation

Question 5
Contrast the above x-ray with the following x-ray. What is this type of fracture called and what is the difference?

Frontal Case Source
Lateral

Lateral

Answer:
Monteggia fracture: ulnar fracture with proximal radial head dislocation. One mnemonic to remember the difference between galeazzi and monteggia fractures is GRIMUS (G-Galeazzi, R-Radius, I-Inferior; M-Monteggia, U-Ulnar, S-Superior).