Clincal Conditions Flashcards
What is syndactyly?
Two or more digits fused together
What is polydactyly?
Having extra digits
What is Amelia?
Lacking 1+ limbs or having 1+ shrunken/deformed limbs
What is meromelia?
Lacking part of 1+ limbs but still have the presence of hand/foot
Have a shrunken/ deformed extremity
What are the two types of hip fractures?
Intracapsular and extracapsular
What are the main difference in the types of hip fractures? (2)
- Intracapsular affects more elderly and female people, whilst extra-capsular affects more young/middle aged people
- Intracapsular leads to avascular necrosis because there is damage to the medial circumflex artery, whilst there isn’t any in an extra-capsular fracture
What artery is at risk following an intracapsular hip fracture?
Medial circumflex artery
What happens to the lower limb following a hip fracture? Why?
Shorter and toes pointing out
Because the distal fragment of the fracture is pulled up and rotated laterally
What are the 3 types of humeral fractures that can occur?
- Surgical neck
- Midshaft
- Distal
How might you get a surgical neck humeral fracture?
FOOSH or direct blow
What are the structures at risk after a surgical neck fracture? (2)
Axillary nerve
Posterior circumflex artery
What might be the consequences of axillary nerve damage following a surgical neck fracture of the humerus?
- Paralysis of deltoid and teres minor therefore difficulty abducting
- Sensation loss/impairment in regimental badge region (distal fibres of delt)
What structures are most at risk during a mid-shaft humeral fracture? Why? (2)
- Radial nerve
- Profunda brachii artery
As they are both tightly bound in the radial groove
What occurs after radial nerve damage during a mid-shaft humeral fracture? Why?
Wrist drop
Extensors (supplied by nerve) are paralysed, meaning there is unopposed flexion of the wrist.
What are the effects on sensory function of the radial nerve during a mid-shaft humeral fracture?
There is some loss over the dorsal surface of the hand and the proximal ends of the lateral 3 and a half fingers dorsally
What are the 2 common types of distal humeral fractures?
- Supracondylar fractures
2. Medial epicondyle fractures
What is a supraepicondylar fracture and how might it occur?
A transverse fracture. Spanning between the two epicondyles
Occurs by falling on a flexed elbow
What structure is at risk from a distal humeral fracture?
Brachial artery
What is the effect of direct damage/post fracture swelling on the brachial artery in the cubital fossa?
Ischaemia cuasing Volkmans ishaemic contracture
Damage to median, ulnar or radial nerves
What is volkmans ischaemic contracture?
Uncontrolled flexion of the hand as flexor muscles become fibrotic and short.
What nerve can a medial epicondyle fracture cause damage to? What will this result in?
Ulnar
Ulnar claw, loss of sensation over the medial 1 and a half fingers on the hand, on both the dorsal and palmar surfaces too
What can someone with ulnar claw not do with their hand?
Extend all fingers (medial 2)
What is congenital hip dislocation also called?
Developmental dysplasia of the hip (DDH)
Why does DDH occur?
Because the hip joint does not develop properly in utero
What are the common clinical features of congenital hip dislocation? (3)
- Limited abduction at the hip joint
- Limb length discrepancy (affected limb is shorter)
- Asymmetrical gluteal or thigh skin folds
How is DDH (developmental dysplasia of the hip) treated?
With a Pavlik harness- holds femoral head in place and promotes normal development of joint
Surgery may be needed for those who don’t respond to harness treatment
How are dislocations of the shoulder described?
By where the humeral head lies in relation to the infraglenoid tubercle
What type of shoulder dislocation is more common?
Anterior
What stops superior movement of the humeral head?
The coraco-acromial arch
What is the movement that causes an anterior dislocation? Why?
Excessive extension and lateral rotation of the humerus, the head of the humerus is forced anteriorly and inferiorly into the weakest part of the joint capsule
**tearing the joint capsule is associated with an increased risk of future dislocations
What structure(s) is at risk during shoulder dislocation?
Axillary nerve (it runs in close proximity to the shoulder joint)
Radial nerve can be stretched as it is tightly bound in the radial groove