Common Fractures

Question 1

Mallet Finger

Answer 1

Disruption of extensor mechanism, avulsion fx
MOI: Forced flexion of extended DIP
Rx: Splint in extension (6 weeks), then initiate AROM

Question 2

Boxer’s Fracture

Answer 2

Fracture of 4th and/or 5th
MOI: Blow with a clenched fist
Rx: Closed reduction and casting; ORIF if badly displaced

Question 3

Bennett’s Fracture

Answer 3

Fracture/Dislocation of base of 1st metacarpal
MOI: Axial loading of partially flexed thumb
Rx: Closed reduction with thumb spica or ORIF

Question 4

Scaphoid Fracture

Answer 4

Adolescents and YA, AVN and non-union (if fx involves proximal pole)
MOI: FOOSH
Rx: Closed reduction and casting; ORIF is displaced

Question 5

Triquetral Fracture

Answer 5

MOI: FOOSH in ulnar deviation; direct blow to dorsum of hand
X-Ray in Lateral View
Rx: Closed reduction and casting

Question 6

Lunate Dislocation

Answer 6

Displacement and volar rotation of lunate
MOI: high energy hyperextension and ulnar deviation; fall or MVA
Rx: urgent open reduction and surgical repair

Question 7

Perilunate Dislocation

Answer 7

Dislocation of carpals relative to lunate (w/ scaphoid fx)
MOI: Same as lunate dislocation
Rx: Immediate open reduction and surgical repair

Question 8

Colle’s Fracture

Answer 8

Transverse fx of distal radius with dorsal/later displacement (osteoporosis)
MOI: FOOSH
Rx: Closed reduction and casting if not comminuted; ORIF if comminuted

Question 9

Smith’s Fracture

Answer 9

Fracture of distal radius with palmar/medial displacement; young men or fall/blow to back of hand

Question 10

Monteggia Fracture

Answer 10

Fx of proximal or mid 1/3 ulna with radial head dislocation (overlooked)
MOI: FOOSH or direct blow (MVA)
Rx: ORIF and immobilization

Question 11

Galeazzi Fracture

Answer 11

Fx of distal 1/3 of radius with distal radioulnar joint disruption
MOI: FOOSH or direct blow (MVA)
Rx: ORIF and rigid immobilization

Question 12

Greenstick Fracture

Answer 12

children, periosteal sleeve intact
MOI: Bending force, fall or blow
Rx: Cast immobilization

Question 13

Radial Head Fracture

Answer 13

Valgus fore impaction of capitellum onto radial head

MOI: Axial loading on pronated and partially flexed/outstretched arm

Question 14

Proximal Humeral Fracture

Answer 14

older individuals
MOI: FOOSH or elbow; direct blow
Rx: Closed reduction and immobilization (80%), ORIF

Question 15

Humeral Shaft (Diaphyseal) Fracture

Answer 15

MOI: direct (transverse) blow; indirect trauma from fall or twisting (oblique or spiral)
Rx: Closed reduction and immobilization, ORIF

Question 16

Humeral Fracture

Answer 16

Diaphyseal (younger), Proximal (Older), or distal (children)
MOI: FOOSH or elbow; direct blow
Rx: Closed reduction and immobilization (80%), ORIF

Question 17

Supracondylar Fractures

Answer 17

Extra-articular or intra-articular, 90% in children
MOI: Fall onto hyperextended or flexed (rare) elbow
Rx: Closed reduction and immobilization if minimal displacement; ORIF

Question 18

Distal Humeral Fractures

Answer 18

epicondyles, trochlea, capitellum and/or metaphysis
MOI: High energy trauma (younger); falls (older)
Rx: ORIF