Clinicals Of Osteology

Question 1

Fracture of clavicle

Answer 1

Medial 2/3 lateral 3rd

Sternocleidomastoid elevates medial part but trapezius can’t elevate lateral part this causing dropping shoulders
Other limb is used for support

Strong coracoclavicular ligaments prevents dislocation of ac joint

Question 2

Ossification of clavicle

Answer 2

Congenital defect
Fusion of two ossification centers of clavicle may fail to occur and bony defect forms btw medial and lateral clavicle.
This is often mistaken for fracture.

Question 3

Fracture of scapula

Answer 3

Usually results from pedestrian vehicle accidents
Fractured ribs sometimes
Sometimes involves protruding subcutaneous acromion

Question 4

Fractures of humerus

Answer 4

Fracture of surgical neck, common in elderly with osteoporosis

Avulsion (torn away) Fracture of greater tubercle of humerus
Muscles which remain attached pull humerus into medial rotation

Fracture of shaft usually from direct blow or torsion to arm. Types here are:
Greenstick (usually in children), transverse fracture which the pull of the deltoid carries proximal fragment laterally, oblique fracture from fall on an outstretched hand,

Question 5

Parts of humerus in direct contact with nerves in which a fracture would result in its damage

Answer 5

Surgical neck with axillary nerve
Radial groove with radial nerve
Distal end of humerus with median nerve
Medial epicondyle with ulnar nerve

Question 6

Fracture of radius and ulna

Answer 6

Usually greenstick in children
Direct injury usually produces transverse fractures at same level
Fracture of distal end of radius usually in women with osteoporosis

Question 7

Colle’s fracture of radius aka dinner fork deformity

Answer 7

Complete transverse fracture (most common) of distal 2cm of radius is colles fracture
Usually due to trying to ease out a fall with an outstretched hand or forced extension of hand

Question 8

What is also known as dinner fork deformity?

Answer 8

Colles fracture

Question 9

Fracture of scaphoid

Answer 9

Most frequently fractured
Fall on an abducted hand
Pain in anatomical snuff box during palpation
Usually not seen in radiographs but 10-14 days after due to bone resorption
Poor blood supply to proximal parts of scaphoid (avascular necrosis) delays healing or even leads to death of bone . Fusion of carpals may be necessary in some cases

Question 10

Fracture of hamate

Answer 10

Ulnar nerve which is close to hook of hamate may be injured
Also ulnar artery

Question 11

Fracture of metacarpals

Answer 11

Severe crushing injuries of hand
Fracture of 5th metacarpal also called boxer’s fracture due to punching with a closed fist. Head of bone rotates over distal end of shaft causing flex ion deformity.
Good blood supply causes rapid healing

Question 12

Fracture of phalanges

Answer 12

Crushing injuries extremely painful due to developed sensation in fingers
Usually comminuted and painful hematoma (collection of blood) usually develops
Hyperextension injuries

Question 13

Boxers fracture is as a result of?

Answer 13

Fracture of 5th metacarpal