Forearm Fractures and Instabilities-Forearm Instability: Anatomy, Biomechanics, and Treatment Options

Forearm Instability: Anatomy, Biomechanics, and Treatment Options

Pdf Summary

This article discusses forearm instability, focusing on the anatomy, biomechanics, and treatment options for this condition. The forearm unit consists of the radius and ulna, along with several joints and soft tissue stabilizers. Disruptions in these structures can lead to forearm instability. The primary stabilizer of the forearm is the radial head, with the triangular fibrocartilage complex (TFCC) and interosseous membrane (IOM) playing secondary roles. <br /><br />The IOM is a structure between the radius and ulna that provides stability to the distal radioulnar joint and the forearm. It has been found to have five distinct components, the most important being the central band. Injuries to this band can result in longitudinal forearm instability. <br /><br />The article also discusses specific injury patterns and their treatment. Galeazzi fracture-dislocation involves a fracture of the radial shaft and disruption of the distal radioulnar joint. Treatment typically involves surgical fixation of the radius and stabilization of the joint. Monteggia fracture-dislocation is a fracture of the ulna with radial head dislocation. Treatment requires anatomical reduction and fixation of the ulna. <br /><br />The most complex form of forearm instability is the Essex-Lopresti injury, which involves multiple injuries to the radial head, IOM, and TFCC. Treatment for this condition often includes reconstruction of the radial head, repair of the TFCC, and stabilization of the IOM.  In some cases, a one-bone forearm procedure may be necessary.  The article emphasizes the importance of early recognition and intervention in order to achieve optimal outcomes.

Keywords

forearm instability

anatomy

biomechanics

treatment options

radius

ulna

distal radioulnar joint

Galeazzi fracture-dislocation

Monteggia fracture-dislocation

Essex-Lopresti injury