Inquire about weakness, numbness, paresthesias, and radiating pain. High mechanism crush injuries merit a detailed neurovascular exam with repeat serial exams looking for signs of acute compartment syndrome. A fall on an outstretched hand should raise suspicion for a wrist injury, and particular attention should be paid to the stability of the DRUJ. Stability of the proximal and distal joints should be assessed to identify concomitant injuries. Gentle palpation should be performed to identify deformities and focal tenderness. It is essential to identify wounds overlying fracture sites (i.e., open fracture), which necessitates immediate surgical intervention. An examination should begin with a visual inspection of the skin and soft tissue paying close attention to visible bony deformities, skin lacerations, muscle contusions, tendon damage and neurovascular deficits. Patients with diaphyseal forearm fractures typically complain of pain at the site of injury. They found stability to be dependent on the distance of the radial fracture from the distal radial articular surface: The second classification system is based on Rettig ME and Raskin KB who categorized Galeazzi fractures based on fracture stability. The first classifications were based on the position of the distal radius: Two classification systems have been proposed when categorizing Galeazzi fractures. Distally the radius connects with the lunate and scaphoid bones of the wrist. The proximal radial head articulates with the capitellum of the humerus (radiocapitellar joint), rotating within the annular ligament during pronation and supination. Distally the ulnar head serves as an insertion point for the TFCC, supplementing the DRUJ. Proximally the ulna consists of the olecranon and coronoid. The radiocapitellar joint largely stabilizes the proximal forearm while the TFCC predominantly supports the distal forearm. The interosseous membrane is responsible for dispersing axial load force to the forearm, 60% to the radiocapitellar joint and 40% to the ulnohumeral joint. The radius and ulna are stabilized by three groups of ligamentous structures: distally the triangular fibrocartilage complex (TFCC), the interosseous membrane, and proximally the annular ligament. The osseous forearm is composed of the radius and ulna bones.
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