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April 1, 1939

FRACTURE OF THE SHAFT OF THE ULNA: WITH DISLOCATION OF THE HEAD OF THE RADIUS

Author Affiliations

Passed Assistant Surgeon, U. S. Public Health Service SEATTLE, WASH.

JAMA. 1939;112(13):1241-1244. doi:10.1001/jama.1939.02800130025008
Abstract

When the ulna is fractured, what happens to the radius? Usually it is fractured also, but if not, what then? Almost invariably in the case of indirect violence, and frequently in the case of direct violence, if the radius is not fractured, the radial head is dislocated. Unless one is specifically looking for it (and particularly if the elbow joint is not included in the roentgenogram) a dislocated radial head can easily be overlooked until the patient's continuing disability two or three months later forces a readjustment of the surgeon's complacency that "only the ulna was fractured."

The dislocation of the radial head is overlooked largely because most physicians have not been trained to look for it. The ulnar fracture is frequently 3 or 4 inches (7.6 or 10 cm.) below the elbow; attention is immediately centered on the obvious lesion, and unless one's first reaction on seeing a fracture

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