Figure 17.1
Radiographs of an isolated radial shaft fracture in a skeletally mature patient. In this fracture pattern, often called a “Galeazzi fracture,” the distal radioulnar joint is often disrupted
What to Ask
- 1.
Is the fracture open? Subtle abrasions or very small lacerations may indicate open fractures.
- 2.
What is the neurovascular exam? Ensure there are good pulses or signals by Doppler probe.
- 3.
What is the exam of the forearm compartments? Late presentation or high-energy injuries are at greater risk for development of compartment syndrome.
- 4.
What was the mechanism of the fracture? High energy injuries may have associated injuries or develop compartment syndrome. Low-energy ulnar shaft fractures may be a result of injuries sustained during an altercation requiring appropriate privacy and protection of the patient within the emergency department.
What to Request
- 1.
Patient should be immobilized until you arrive.
- 2.
Analgesia with or without anxiolytic/antispasmodic for comfort.
When to Escalate
- 1.
Open injuries
- 2.
Concern for compartment syndrome
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