The radius is on the side of the thumb and is one of the long bones of the forearm. Together with the ulna and humerus, it ensures proper functioning of the upper limb. Find out what abnormalities can occur in the radius bone and how to deal with them.
The radiusis a long bone and belongs to the upper limb, specifically the forearm. The radius is closest to the thumb. The greatest forces act on the radius, which is why fractures quite often occur.
Radius bone - structure
The radius is a long bone. It consists of a shaft and two ends. The bone shaft has a triangular cross-section and three edges:
- front,
- back
- and interosseus
and three surfaces:
- front,
- back
- and side.
The strongest edge separating the anterior and posterior surfaces, facing medially to the ulna, is called the interosseous edge. The anterior thickened edge of the shaft passes downwards into a styloid process.
The dorsal surface of the distal end has grooves for the extensor tendons of the wrist, thumb, index and finger extensor. The distal end and the proximal end have two articular surfaces.
The end closest to the radius connects to the head of the humerus. It ends with a head in the shape of a short cylinder, on which there are two articular surfaces.
The forearm bones are adjacent to each other - the articular circumference of the radial head fits perfectly to the radial notch of the ulna.
Below the head there is the neck and the tuberosity of the radial bone. The tendon of the biceps brachii muscle attaches to the posterior, rough part of the tuberosity. On the front, smooth part there is a synovial bursa.
Radius bone - joints
The radial brachial joint is formed by the head of the radial bone together with the head of the humerus. The pond is spherical and has two axes. Enables the movement of turning and flipping the forearm.
The radial-elbow joint is a pivot joint. The head is formed by the articular circumference of the radial head, and the acetabulum - the radial notch of the ulna and the annular ligament. Allows you to turn and flip the forearm.
The surfaces of the distal radioulnar joint correspond to those in the proximal joint, but the radius and ulna change function - the acetabulum is the radius bone, the head is the ulna bone.
What can be felt on the surface of the radius? On the radius, the lateral and posterior surfaces of the head, the middle and lower parts of the shaft and the styloid process are palpable.
Radius bone - types of injuries and fractures
Fractures of the radial head
Fractures of the radial head account for approximately 30% of the elbow fractures.
Break:
- Marginal fracture of the head without displacement.
- Marginal fracture of the head with displacement. Both types of fractures may occur when a fall on the upper limb straightened in the elbow joint.
- Fracture of the neck or exfoliation of the epiphysis of the radius. Exfoliation of the epiphysis of the radius is most common in children aged 8-12 years.
- Multi-fragmented head fracture with splitting and displacement of the fragments.
Symptoms are characteristic of fractures:
- pain increasing with movement,
- limb mobility restriction,
- swelling,
- bruising.
It is necessary to perform an X-ray imaging of both bones in the forearm and the distal radioulnar joint in the anteroposterior and lateral views. Nonsurgical treatment is used in the case of non-displaced fractures. A plaster cast should be applied for about 2-3 weeks.
Mixed fractures require an attitude. A strong lift is made in the forearm axis. Then the bone fragment is placed in the right place. The limb is immobilized for 3 weeks in a shoulder plaster.
Exfoliation with displacement of fragments up to about 45% in children under the age of 5 can be left.
In the case of radial head fractures, the condition of the ulnar collateral ligament should be assessed. Displaced radial head fractures may be accompanied by collateral ligament injuries, joint capsule, and fractures of the humerus and ulna.
Surgical treatment is used in adults in the case of fractures with displacement and fragmentation of the radial head, its early excision is performed. This prevents damage to the articular surface of the humeral head. The removed head can be replaced with an endoprosthesis. Computed tomography is helpful in assessing the extent of the fracture and the degree of dislocation of the fragments.
Congenital absence or underdevelopment of a radial bone
In this defect there is an underdevelopment of the radial part of the upper limb andtwisting the forearm axis towards the radial side. As the child grows, the distortion gets worse. Treatment consists of an operation that should be performed in the first year of life.
Fracture of the distal epiphysis of the radius
This is one of the most common fractures of the upper limb. Usually it is formed by a fall on an extended upper limb or, less frequently, on a bent limb. In the extension fracture, the distal fracture moves towards the dorsal and radial sides and undergoes inversion.
In a flexion fracture, the distal fracture shifts in the hand and elbow and undergoes slight conversion. These fractures are usually unstable and difficult to treat. Very often, these fractures are accompanied by other damage, e.g. styloid fracture of the ulna, fracture of the scaphoid.
Break:
- Extra articular fractures: extension, or Colles, and flexion, also known as Smith's fracture
- Intra-articular fractures arising from the action of shear forces
- Crushing fractures of the distal epiphysis of the radius
- Avulsion fractures causing damage to the ligaments connecting the forearm to the wrist and its instability
- Exfoliation of articular cartilage
Nonsurgical treatment consists in setting a displaced fracture and immobilizing the limb with a plaster cast. Immobilization lasts for 4-6 weeks. The upper limb should be X-ray checked immediately after setting, after 7-10 days, as it may cause dislocation.
Magnetic resonance imaging also allows the assessment of discrete fractures and contusions, or rupture of the interosseous membrane. Surgical treatment is necessary for open, unstable, secondarily displaced fractures, and fractures associated with vascular and nerve damage.
Monteggia fracture
Accounts for approximately 5% of forearm fractures. It is a fracture of the upper shaft of the ulna with dislocation of the head of the radial bone. In children, peeling of the radial head is often found. This fracture may be associated with damage to the radial nerve by the head of the radial bone.
There are different types of this injury:
- extension fracture- otherwise known as a gladiatorial fracture, most often occurs as a result of a direct blow to the forearm. It is the most common and accounts for about 80% of cases. Affects 1/3 of the proximal and middle ulna, headthe radius is dislocated forward and the ulna bone is bent forward
- flexion fracture- occurs rarely, usually due to a fall on the forearm, slightly bent at the elbow joint. It is associated with a fracture of the proximal end of the ulna, posterior or posterolateral dislocation of the head of the radius, and bending of the ulna fragment backwards.
- adduction fracture- occurs very rarely, the ulna is fractured slightly distal from the styloid process with lateral bend of the fragments, the head of the radial bone also moves laterally
- fracture of the ulna at 1/3 proximal or middlewith anterior dislocation of the head of the radius and fracture of the proximal end of the radius and ulna. A fracture can be diagnosed by radiographing both bones in the forearm showing the radioulnar joints in the antero-posterior and lateral positions. Treatment in children is conservative and consists in adjusting the fracture. Immobilization in a plaster cast should be maintained for 10-12 weeks in adults and 6-8 weeks in children. Flexion fractures are easier to set, and immobilization occurs when the joint is bent up to 90 °, while extension fractures are more difficult to set and should be immobilized when the elbow is bent to an angle of 120 °.
Galeazzi fractures
Fracture of the shaft of the radial in 1/3 of the distal and dislocation of the radioulnar joint. The radius is fractured initially, followed by dislocation of the ulna.
It is necessary to perform an X-ray showing both radial-elbow joints. Due to the fact that they are extremely unstable, these fractures are treated surgically. The radius should be anastomosed and the distal radioulnine joint should be stabilized.
Essex-Lopresti-type fracture
Fracture of the radial head with rupture of the interosseous membrane and dislocation of the distal radioulnar joint. Usually it arises from a fall on a straightened upper limb.
This fracture can be diagnosed by taking an X-ray image in an anterior-posterior and lateral projection, including the elbow, forearm and wrist. One can visualize a fracture fissure within the radius at the distal radioulnar joint. Arthroplasty of the radial head is necessary.
Barton's Break
In Barton's fracture, the continuity of the dorsal edge of the distal radius is broken. It happens that a fracture is accompanied by a dislocation. Best visiblethe fracture is shown in a radiographic imaging examination in a lateral or oblique view.
Hutchinson fracture
It is otherwise known as breaking a chauffeur or a driver. It concerns the lateral edge of the distal end of the radius and runs through the styloid to the articular surface. This fracture is best seen in the anterior-anterior projection in radiographs.
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