My EM Notes

Normal Fat pad

+ve Fat pad sign

stable	• isolated undisplaced or minimally displaced fracture • nearly always impacted, with intact periosteum, and are unlikely to displace. • Mx - conservative. Stiffness is the main adverse outcome and neither immobilisation or early mobilisation are necessarily superior
unstable	• usually associated with other bony or ligamentous injury • usually involve several detached, mobile fragments with little or no soft-tissue attachment • often associated with an elbow dislocation, proximal ulna fracture, or injury to the interosseous ligament of the forearm

Mason Classification (Modified by Hotchkiss and Broberg-Morrey)
Type I	Nondisplaced or minimally displaced (<2mm), no mechanical block to rotation
Type II	Displaced >2mm or angulated, possible mechanical block to forearm rotation
Type III	Comminuted and displaced, mechanical block to motion
Type IV	Radial head fracture with associated elbow dislocation

Essex-Lopresti fracture-dislocation

fracture of the radial head, dislocation of the distal radioulnar joint and rupture of the antebrachial interosseous membrane
possibly only 20% recognised at 1st presentation as XRay may be unremarkable

Bado classification of Monteggia fracture-dislocation
I	anterior dislocation of radial head
II	posterior dislocation of radial head
III	lateral dislocation of radial head
IV	anterior radial head dislocation as well as proximal third ulnar and radial shaft fractures

fracture of the distal part of the radius with dislocation of distal radioulnar joint and an intact ulna.
A Galeazzi-equivalent fracture is a distal radial fracture with a distal ulnar physeal fracture.
due to a fall on an outstretched hand (FOOSH) with the elbow in flexion
type I: dorsal displacement, type II: volar displacement

Monteggia vs Galeazzi
	“GRIMUS” Galleazzi Radial fracture (Inferiorly ie. distal) Monteggia Ulna fracture (Superiorly ie. prox)