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Ulnar fracture and radial head dislocation

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

Fall onto outstretched arm from monkey bars. Deformed forearm and pain.

Patient Data

Age: 6 years
Gender: Male

Obvious fracture of the ulna diaphysis. On the lateral view you might be tempted to call this a greenstick fracture but if you look carefully, the fracture extends all the way through the bone and, on the AP, there is malalignment.

On the lateral, the radial head does not align with the capitellum - it is dislocated.

Case Discussion

Do not undercall this as an incomplete greenstick fracture when it is a diaphyseal oblique fracture and there is an associated radial head dislocation.

When there is a radial or ulnar shaft fracture, look specifically for a fracture of the other bone, or a dislocation of the radial head or distal radioulnar joint.

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