The forearm is composed of two bones: the radius and the ulna.
The radius and ulna are connected by an interosseous membrane.
The wrist is a complex joint comprising eight carpal bones: scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate.
Ligaments, tendons, and nerves surround and support the wrist and forearm bones.
Common Injuries
Colles' Fracture
Definition: A fracture of the distal radius bone in the forearm.
Pathology: Caused by a fall onto an outstretched hand, resulting in a displacement of the distal fragment.
Clinical Features:
• Pain and swelling in the wrist and forearm.
• Deformity of the wrist with a characteristic "dinner fork" appearance.
• Limited mobility and tenderness.
Investigations: Radiographs, CT scans, or MRI may be used to confirm the diagnosis.
Management: Immobilization in a cast or splint for 4-6 weeks, followed by physical therapy.
Complications: Nonunion, malunion, or complex regional pain syndrome.
Monteggia Fracture
Definition: A fracture of the ulna with dislocation of the radiocapitellar joint.
Pathology: Caused by a fall onto an outstretched hand, resulting in a fracture of the ulna and dislocation of the radius.
Clinical Features:
• Pain and swelling in the forearm and elbow.
• Deformity of the forearm with a characteristic "garden spade" appearance.
• Limited mobility and tenderness.
Investigations: Radiographs, CT scans, or MRI may be used to confirm the diagnosis.
Management: Immobilization in a cast or splint for 4-6 weeks, followed by physical therapy.
Complications: Nonunion, malunion, or complex regional pain syndrome.
Galeazzi Fracture
Definition: A fracture of the radius with dislocation of the distal radioulnar joint.
Pathology: Caused by a fall onto an outstretched hand, resulting in a fracture of the radius and dislocation of the ulna.
Clinical Features:
• Pain and swelling in the wrist and forearm.
• Deformity of the wrist with a characteristic "dartboard" appearance.
• Limited mobility and tenderness.
Investigations: Radiographs, CT scans, or MRI may be used to confirm the diagnosis.
Management: Immobilization in a cast or splint for 4-6 weeks, followed by physical therapy.
Complications: Nonunion, malunion, or complex regional pain syndrome.
Smith's Fracture
Definition: A fracture of the distal radius with a volar tilt.
Pathology: Caused by a fall onto an outstretched hand, resulting in a fracture of the distal radius.
Clinical Features:
• Pain and swelling in the wrist and forearm.
• Deformity of the wrist with a characteristic "garden spade" appearance.
• Limited mobility and tenderness.
Investigations: Radiographs, CT scans, or MRI may be used to confirm the diagnosis.
Management: Immobilization in a cast or splint for 4-6 weeks, followed by physical therapy.
Complications: Nonunion, malunion, or complex regional pain syndrome.
Imaging Interpretation
Radiographs are the primary imaging modality for forearm and wrist injuries.
CT scans or MRI may be used to confirm the diagnosis, particularly in complex cases.
Radiographs should be evaluated for displacement, angulation, and rotation of the bones.
Emergency Management
The primary goal of emergency management is to stabilize the injured limb and prevent further injury.
Immobilization in a cast or splint is often necessary to maintain alignment and reduce pain.
Pain management with analgesics and anti-inflammatory medication is essential.
Early follow-up with an orthopedic specialist is recommended to assess the severity of the injury and plan further management.
Homoeopathic Therapeutic Approach
Arnica 30C: For pain, swelling, and bruising.
Ruta 30C: For bone pain and fractures.
Hypericum 30C: For nerve pain and injury.
Ledum 30C: For swelling and bruising.
Indications for Surgery
Open fractures or wounds.
Displaced fractures or dislocations.
Complex regional pain syndrome.
Nonunion or malunion.
Persistent pain or limited mobility despite conservative management.