Ulnar fracture x ray
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Ulnar fracture x ray On the Web |
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American Roentgen Ray Society Images of Ulnar fracture x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;
Overview
The configuration of midshaft fractures of the ulnar fracture varies depending on the mechanism of injury and the degree of violence involved. Low-energy fractures tend to be transverse or short oblique involvements, but high-energy injuries are commonly comminuted or segmented with extensive soft-tissue injuries. Computed tomography (CT) is useful in distal radius fractures and ulnar joint pathologies.
X-Ray evaluation
The orthopedic surgeon should consider to have at least two radiographic projections (ie, anteroposterior [AP] and lateral) of the forearm. These show the fracture, the extent of displacement, and the extent of comminution. The orthopedic surgeon should pay serious attention toward finding any foreign bodies in open fractures and gunshot injuries. Also imperative is to include the elbow and wrist joint in the radiographs of ulnar fractures to ensure that the distal radioulnar joint injuries are not missed.
A tuberosity view is helpfull ascertain the rotational displacement of the fracture. Also, it would be helpful for the orthopedic surgeon in planning how much supination or pronation is needed to achieve accurate anatomic reduction. The ulna is laid flat on the cassette with its subcutaneous border in contact with the cassette; the x-ray tube is tilted toward the olecranon by 20°. This radiograph is then compared with a standard set of diagrams that show the prominence of the radial tuberosity in various degrees of pronation and supination in order to determine the scope of the rotational deformity.
Ultrasonography
Angiography or vascular Doppler ultrasonography is useful to determine the level of vascular injury in selected cases where vascular injury is suspected. Point-of-care ultrasonography (POCUS) has been used to diagnose distal forearm fractures in pediatric emergency departments.
CT Scan Evaluation
Its been reported that the articular fractures of the distal radius were statistically more likely to occur at the intervals between the ligament attachments than at the ligament attachments. The most common fracture sites were the center of the sigmoid notch, between the short and long radiolunate ligaments, and the central and ulnar aspects of the scaphoid fossa dorsally. These results suggest that CT may be used to identify the subsequent propagation of the fracture and the likely site of the impaction of the carpus on the distal radius articular surface.
MRI
Magnetic resonance imaging (MRI) is of limited utility in radioulnar injuries and is not indicated in uncomplicated forearm fractures.