Forearm and arm fractures Flashcards
What structures form a ring in the forearm?
Ulna
Radius
What are some possible fracture patterns in forearm fractures?
- Monteggia fracture
- Galeazzi fractures
- Gearstick fracture
What are Monteggia fractures?
Monteggia fractures are ulnar shaft fractures with radial head dislocation most commonly occurring in children
What are Galeazzi fractures?
Galeazzi fractures are radial shaft fractures with ulnar dislocation at the wrist
What are Nightstick fractures?
Nightstick fractures are fractures to the ulnar shaft, usually caused by defence against a blunt object (Hence gearstick, as common in police use of nightsticks)
What is shown in this X-ray?
Monteggia fracture
What is shown in this X-ray?
Galeazzi fracture
What is shown in this X-ray?
Nightstick fracture
How are forearm fractures in children commonly managed?
Conservative management using a cast is common in children, as they heal more quickly than an adult would
When is surgical management used in forearm fracture?
If there is fracture to both bones or dislocation, surgical management is common to re-establish rotational control
What is the main surgical management in forearm fracture?
ORIF
What is the most common cause of olecranon fracture?
Falling onto the elbow
What is a possible complication of olecranon fracture?
Damage to insertion of triceps tendon
What is shown in this X-ray?
Olecranon fracture
What is the main conservative management of olecranon fracture?
Casting
What are some forms of surgical management used in olecranon fracture?
Tension band wiring
ORIF
What does tension band wiring involve?
Tension band wiring involves a figure-of-8 wire being passed around the fracture
What are some possible causes of humeral shaft fracture?
Falls
Direct trauma
What fracture patterns are usually found in humeral shaft fractures caused by falls?
Oblique fracture
Spiral fracture
What fracture patterns are usually found in humeral shaft fractures caused by direct trauma?
Transverse fractures
Comminuted fractures
Why do most humeral shaft fractures require only conservative management?
They have a very good blood supply so most will not require surgery
What are some forms of conservative management in humeral shaft fracture?
Humeral brace
U-slab cast (Uncommon)
What are some surgical managements of humeral shaft fracture?
IM nailing
ORIF
What nerve is at risk of damage in humeral shaft fracture?
Radial nerve
What clinical sign will be present if there is radial nerve damage in humeral shaft fracture?
Wrist drop
Where is the most common site of proximal humerus fracture?
Surgical neck of the humerus
Who is most likely to fracture their surgical neck of humerus?
Osteoporotic patients during low energy falls
What nerve is at risk in surgical neck of humerus fracture?
Axillary nerve
What is the clinical sign associated with axillary nerve damage in surgical neck of humerus fracture?
Loss of full abduction
Who is conservative management of humerus surgical neck used in?
Elderly
What is involved in conservative management of proximal humeral fracture?
Colar and cuff
Who is surgical management of humerus surgical neck used in?
Severe cases
Young patients
What surgical management option is used in proximal humeral fracture?
ORIF
Shoulder replacement
