Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following high-energy trauma to the forearm with reported deformity and localized pain. Mechanism of injury consistent with axial load on a pronated forearm. Patient reports immediate loss of function, significant swelling, and neurovascular compromise symptoms.
Clinical Examination Findings
Physical exam reveals obvious deformity of the distal forearm and wrist. Tenderness noted over the distal radial shaft and distal radioulnar joint (DRUJ). Skin integrity intact, but significant soft tissue swelling present. Neurovascular assessment: distal pulses (radial/ulnar) present/absent, capillary refill <2s, sensation intact/diminished in median/ulnar/radial nerve distributions.
Treatment Protocol
Immediate stabilization via splinting. Radiographic confirmation of radial shaft fracture and DRUJ disruption. Plan: Open Reduction and Internal Fixation (ORIF) of the radial fracture using plate and screw construct. Intraoperative assessment of DRUJ stability; if unstable, transfixion with K-wires or secondary stabilization required. Post-operative immobilization in a sugar-tong or long-arm splint.