Forearm ORIF

Case contributed by Amanda Er
Diagnosis certain


Fell from ladder at height of 80cm, with right elbow pain. Open reduction and internal fixation performed 1 day after initial presentation.

Patient Data

Age: 40 years
Gender: Male

Initial presentation


There is a displaced comminuted fracture of the right proximal radial shaft with overlap of the fracture fragments. Associated dislocation of the radial head is noted. An elbow joint effusion is seen, with the distal radial ulnar joint appearing intact.

Post operative


Tiny density seen adjacent to the dorsolateral aspect of the coronoid may represent a tiny osteochondral body. Despite the overlying backslab obscuring bony detail, there is suggestion of a small elbow joint effusion. Interval reduction of the radio-capitellar articulation is noted, with the bony alignment of the radial shaft significantly improving following internal fixation.

Case Discussion

This patient sustained a fracture-dislocation to their right radius, with an open reduction internal fixation (ORIF) carried out 1 day after his initial trauma.

Note: The Monteggia fracture-dislocation and Galeazzi fracture-dislocation should not be confused for what has actually occurred in this particular case.

Monteggia fracture-dislocations are made of:

  • a fracture of the ulnar shaft
  • with concomitant dislocation of the radial head

Galeazzi fracture-dislocation consists of:

  • a fracture of the distal radius
  • dislocation of the distal radioulnar joint
  • an intact ulna

For various ways to remember their differences, see the mnemonic article on the two types.

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