Causes / typical injury mechanism:

• Motor vehicle accident
• Fall from height with axial loading through the hand into the forearm
• High-energy direct trauma

Classic history and presentation: History of recent trauma as described above. Presentation will include pain, especially with forearm rotation, wrist movement, or finger movement; swelling; and possible deformity. The incidence of open fractures is very high compared to other fractures.

Prevalence:

• Age – More common in younger patients.
• Sex / gender – More common in men than in women.

Risk factors: Sports (especially contact sports or motor vehicle sports), industrial / construction / similar employment.

Descriptive classification:

• Closed versus open
• Location – Distal, mid-shaft, proximal
• Comminuted, segmental, multifragmented
• Displacement
• Angulation
• Rotational alignment

Orthopaedic Trauma Association (OTA) classification:

• Type A – Simple fracture of ulna (A1), radius (A2), or both bones (A3)
• Type B – Wedge fracture of ulna (B1), radius (B2), or both bones (B3)
• Type C – Complex fractures

Gustilo-Anderson classification for open bone fractures:

• Type 1 – Wound length < 1 cm; minimal soft tissue damage, contamination, or comminution; periosteum intact; adequate soft tissue coverage; intact vasculature.
• Type 2 – Wound length < 1 cm; moderate soft tissue damage, contamination, or comminution; periosteum intact; adequate soft tissue coverage; intact vasculature.
• Type 3a – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; adequate soft tissue coverage; intact vasculature.
• Type 3b – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; inadequate soft tissue coverage; intact vasculature.
• Type 3c – Wound length > 1 cm; extensive soft tissue damage, contamination, or comminution; periosteal stripping; inadequate soft tissue coverage; arterial damage.