Clinical Applications Flashcards
Acromioclavicular Dislocation
Separated shoulder
Tear or complete rupture of acromioclavicular ligament - might also involve coracoclavicular ligaments
Presentation of acromioclavicular dislocation
Sharp gap between lateral clavicle and deltoid profile
Weight of upper limb pulls scapula down, contraction of trap pulls lateral clavicle superiorly
Clavicular fracture
USually occurs at junction of middle and lateral thirds
Presentation of clavicular fracture
lump over mid clavicle
SCM muscle pulls medial portion superiorly
pec major pulls arm medially
leads to overriding fragments
Glenohumeral dislocation
described as inferior, superior, anterior or posterior to scapular glenoid
Inferior is most common
Often occurs with loading of humerus in an extended and exteriorly rotated position
Obstacle to sup glenohumeral disloaction
acromion, coracoacromial ligament, and rotator cuff muscles present significant obstacle to superior disloaction
Anterior disloaction to glenohumeral dislocation
more common than posterior
only one ant rotator cuff muscle and two post
long head of triceps is additional barrier to post dislocation
Colle’s Fracture
Fracture of the distal radius often accompanied by avulsion of the ulnar styloid
Most common forearm fracture
Usually occurs in people > 50
Consequence of falling on an outstretched hand
Presentation of Colle’s Fracture
Dorsal displacement of distal fractured portion of radius results in dinner fork presentation
Fracture of the ulnar shaft
Usually as a result of direct trauma to the ulna
If not properly set can form pseudoarthrosis - remodeling of each end of fracture and development of cartialge btw them resulting in mobile joint
Posterior Dislocation of the Elbow
Displacement of ulna and radius posteriorly
Often accompanied by avulsion of coronoid process
Occurs when excessive force is applied to fully extended elbow or when falling forward on flexed elbow
Ulnar Collateral Ligament Injury
Occurs in throwing athletes
Repetitive hyperabduction causes stretching or tearing of ulnar collateral ligament
Surgical repair typically using palmaris longus or plantaris tendon
Radial head dislocation
Nursemaids elbow
Radial head if pulled partially or completely out of the annular ligament
Usually due to sudden pull upward on extended forearm
Scaphoid fracture
Most commonly fractured bone
REsults from a fall on palm of a radially deviated hand
Difficult to diagnose
If undeteced can lead to necrosis due to poor vascularization of proximal part of scaphoid
