RADIUS AND ULNA

BONE
 THE RADIUS
• The proximal end of the radius consists of a head, a neck,
and the radial tuberosity
• The head of the radius is a thick disc-shaped structure
oriented in the horizontal plane.
• The circular superior surface is concave for articulation with
the capitulum of the humerus.
• The thick margin of the disc is broad medially where it
articulates with the radial notch on the proximal end of the
ulna.
• The neck of the radius is a short and narrow cylinder of
bone between the expanded head and the radial tuberosity
on the shaft.
• The radial tuberosity is a large blunt projection on the
medial surface of the radius immediately inferior to the
neck.
• Much of its surface is roughened for the attachment of the
biceps brachii tendon.
• The oblique line of the radius continues diagonally across
the shaft of the bone from the inferior margin of the radial
tuberosity.
• THE SHAFT OF THE RADIUS
• is narrow proximally, where it is continuous with
the radial tuberosity and neck, and much broader
distally, where it expands to form the distal end
• The shaft of the radius is triangular in cross-
section, with:
• Three borders (anterior, posterior, and
interosseous);
• Three surfaces (anterior, posterior, and lateral).
• The anterior border begins on the medial side of
the bone as a continuation of the radial tuberosity
• In the superior third of the bone, it crosses the
shaft diagonally, from medial to lateral, as the
oblique line of the radius.
• The posterior border is distinct only in the middle
third of the bone.
• The interosseous border is sharp and is the
attachment site for the interosseous membrane,
which links the radius to the ulna.
• The anterior and posterior surfaces of the radius are
generally smooth, whereas an oval roughening for the
attachment of pronator teres at the middle of the
lateral surface of the radius.
• anteriorly, the distal end of the radius is broad and
somewhat flattened anteroposteriorly
• The radius has expansive anterior and posterior
surfaces and narrow medial and lateral surfaces.
• Its anterior surface is smooth and unremarkable,
except for the prominent sharp ridge that forms its
lateral margin.
• The posterior surface of the radius is characterized by
the presence of a large dorsal tubercle , which acts as a
pulley for the tendon of one of the extensor muscles of
the thumb (extensor pollicis longus).
• The medial surface is marked by a prominent facet for
articulation with the distal end of the ulna
• The lateral surface of the radius is diamond shaped and
extends distally as a radial styloid process .
• The distal end of the bone is marked by two facets for
articulation with two carpal bones (the scaphoid and
lunate).
• The proximal end of the ulna is much
larger than the proximal end of the
radius and consists of the olecranon, the
coronoid process, the trochlear notch,
the radial notch, and the tuberosity of
ulnaThe
• OLECRANON is a large projection of
bone that extends proximally from the
ulna.
• Its anterolateral surface is articular and
contributes to the formation of the
trochlear notch, which articulates with
the trochlea of the humerus.
• The superior surface is marked by a
large roughened impression for the
attachment of the triceps brachii muscle.
• The posterior surface is smooth, shaped
triangularly, and can be palpated as the “
tip of the elbow. ”
• THE CORONOID PROCESS projects anteriorly
from the proximal end of the ulna
• Its superolateral surface is articular and
participates, with the olecranon, in forming
the trochlear notch .
• The lateral surface is marked by the radial
notch for articulation with the head of the
radius.
• Inferior to the radial notch is a fossa that
allows the radial tuberosity to change
position during pronation and supination.
• The posterior margin of this fossa is
broadened to form the supinator crest .
• The anterior surface of the coronoid process
is triangular, with the apex directed distally,
and has a number of roughenings for muscle
attachment.
• The largest of these roughenings, the
tuberosity of ulna , is at the apex of the
anterior surface and is the attachment site for
the brachialis muscle.
• The shaft of the ulna is broad superiorly where it is continuous
with the large proximal end and narrow distally to form a small
distal head
• the shaft of the ulna is triangular in cross-section and has:
• three borders (anterior, posterior, and interosseous);
• three surfaces (anterior, posterior, and medial).
• The anterior border is smooth and rounded.
• The posterior border is sharp and palpable along its entire
length.
• The interosseous border is also sharp and is the attachment site
for the interosseous membrane, which joins the ulna to the
radius.
• The anterior surface of the ulna is smooth, except distally where
there is a prominent linear roughening for the attachment of the
pronator quadratus muscle.
• The medial surface is smooth and unremarkable.
• The posterior surface is marked by lines, which separate
different regions of muscle attachments to bone.
• The distal end of the ulna is small and characterized by a
rounded head and the ulnar styloid process
• The anterolateral and distal part of the head is covered by
articular cartilage.
• The ulnar styloid process originates from the posteromedial
aspect of the ulna and projects distally
• Colles’ fracture is a fracture of the distal end of the
radius resulting from a fall on the outstretched hand.
• It commonly occurs in patients older than 50 years.
• The force drives the distal fragment posteriorly and
superiorly, and the distal articular surface is inclined
posteriorly
• This posterior displacement produces a posterior
bump, sometimes referred to as the “dinner-fork
deformity” because the forearm and wrist resemble
the shape of that eating utensil.
• Failure to restore the distal articular surface to its
normal position will severely limit the range of
flexion of the wrist joint.
• Smith’s fracture is a fracture of the distal end of the
radius and occurs from a fall on the back of the
hand. It is a reversed Colles’ fracture because the
distal fragment is displaced anteriorly
• A fracture of the head of radius is a common injury It is
one of the typical injuries that occur with a fall on the
outstretched hand.
• On falling, the force is transmitted to the radial head,
which fractures.
• These fractures typically result in loss of full extension,
and potential surgical reconstruction may require long
periods of physiotherapy to obtain a full range of
movement at the elbow joint.
• A lateral radiograph of a fracture of the head of radius
typically demonstrates the secondary phenomenon of
this injury.
• When the bone is fractured, fluid fills the synovial cavity,
elevating the small pad of fat within the coronoid and
olecranon fossae. These fat pads appear as areas of
lucency on the lateral radiograph — the “ fat pad ” sign.
• This radiological finding is useful because fracture of the
head of radius is not always clearly visible.
• If there is an appropriate clinical history, tenderness
around the head of radius and positive fat pad sign, a
fracture can be inferred clinically even if no fracture can
be identified on the radiograph, and appropriate
treatment can be instituted.