Acute Upper Extremity Conditions Flashcards
Ligaments of the shoulder gurdle
Acrominoclavicular
Coracoclavicular
Coracoacromial
Coracohumeral
Clavicle fracture
Most commonly fractured in the lateral 1/3- middle 1/3.
Often causes brachial plexus injury
Caused by trauma and birth
“Foosh injury”
Testing usually includes palpating to determine step off, muscle strength and radial pulse
Treated via sling usually unless displacement is present
AC joints
Usually trauma related
Graded via 1-6
1: AC sprain
2: complete tear of AC and sprain of CC
3: complete tear of AC and CC w/ no displacement
4-6: complete tear of AC and CC w/ variable displacement
Testing includes: palpation for stepoff, scarf/O’Brien’s tests
Glenohumeral dislocations
Caused mostly by trauma
Most common via anterior displacement
Can be accompanied via Labrial tears, hill-Sachs/bankers lesions, and plexus injury’s
Tests: palpate, apprehension/relocation tests, sulcus sign (pull down on arms and the CC joint moves).
Rotator cuff tears
Numerous causes
Tests: palpate, test ROM in shoulder abduction and abduction, medial and lateral rotation of the humerus.
Drop arm test and jobe tests are used.
Incomplete tears are conservatively treated.
Complete tears can be either conversation or surgical (elderly usually conservative, young/trauma usually surgically).
Biceps tendon rupture
Most commonly ruptured tendon in the body.
Makes a POP sound and can appear with “popeye” sign
Tests: palpate, check neruovasculature to rule out compartment syndrome
Hook, squeeze and yergasons test
Usually treated conservative but can be surgical if they need their arm for daily activity such as job
common Humeral fracture locations and respective nerve damage
Surgical neck of humerus: Axillary nerve
Radial groove: radial nerve
Distal end of humerus: median nerve
Medial epicondyle: ulnar nerve
Distal radius fracture
Most common wrist fracture
Often in elderly and can include median nerve entrapment.
Often shows “dinner fork sign” which would signify a collies fracture.
Scaphoid fracture
Most commonly fractured carpal bone
Can cause avascular necrosis (waist or proximal point)
Also has high nonunion chance.
Snuff box pain = scaphoid fracture
May not show in xrays until 10-14 days
Needs thumb spica splint regardless of grade.
Metacarpals and phalanges fractures
Common via trauma and most likely in proximal 4-5 metacarpals
Boxers = 5th metacarpal fracture
Present with overlapping fingers with hand placed on table and possible hematomas.
Treated via splinting above and below fracture, possibly antibiotics if lacerations are present.
Gamekeepers (skiers) thumbs
Damage to ulnar collateral ligament on 1st MCP joint
Presents with serious hyper extension of the thumb.
Tests: laxity of vagus testing and poor ROM. Treated via splinting unless complete tear = surgery.
Jersey finger
Rupture of the FDP tendon at DIP joints (most common at 4th digit but can be any).
Will present with forced extension at rest.
Mallet (baseball) finger
Extensor digitorum tendon of the DIP is torn
Presents with passive hyper flexion
Can have swan neck demotic as a complication if not fixed quickly or poorly immobilizations of the joint for at least 6 weeks
