Fracture Management: Upper Limb

Question 1

what 3 kinds of fracture of the upper arm can you get?

Answer 1

proximal humeral
humeral shaft
distal humeral

Question 2

how should you treat a proximal humeral fracture that is stable/minimally displaced?

Answer 2

conservative with sling

Question 3

how should you treat a displaced proximal humeral fracture

Answer 3

internal fixation

Question 4

what vessels and nerves can be affected in a proximal humeral fracture?

Answer 4

axillary artery

brachial plexus esp axillary nerve (regimental patch)

Question 5

what area of the proximal humerus is most commonly fractured?

Answer 5

surgical neck

Question 6

common cause of a proximal humeral fracture?

Answer 6

low energy fall in osteoporosis

Question 7

how is a humeral shaft fracture managed most commonly?

Answer 7

functional humeral brace

Question 8

what should be done in a distal humeral fracture that is in non-union?

Answer 8

plate and screw

Question 9

what nerve could be injured in a humeral shaft fracture with wrist drop and loss of sensation in 1st dorsal web space

Answer 9

radial

Question 10

what fracture of the humerus is most commonly seen in children?

Answer 10

supracondylar distal humeral fracture

Question 11

management of a distal humeral fracture?

Answer 11

ORIF

elbow replacement if severe

Question 12

management of an olecranon fracture?

Answer 12

ORIF

Question 13

cause of an olecranon fracture?

Answer 13

fall onto point with triceps contraction

Question 14

what sign on x ray indicates a radial head fracture?

Answer 14

fat pad sign

Question 15

how would you manage a stable fracture of the radial head?

Answer 15

conservatively

Question 16

how would you manage a comminuted radial head fracture

Answer 16

excise +/- replacement

Question 17

management of an epicondyle fracture?

Answer 17

screw fixation

Question 18

what fracture has most conservative management of all forearm fractures?

Answer 18

ulnar shaft

Question 19

another word for ulnar shaft fracture?

Answer 19

nightstick fracture

Question 20

management of fractures of both bones of the forearm?

Answer 20

ORIF with plates and screws

Question 21

what is a monteggia fracture dislocation?

Answer 21

ulnar fracture with dislocation of the radial head at the elbow

Question 22

what is a galeazzi fracture?

Answer 22

radial fracture with dislocation of the ulna at distal radioulnar joint

Question 23

how are monteggia and galeazzi fractures managed?

Answer 23

ORIF

Question 24

management of a stable colles fracture?

Answer 24

plaster

Question 25

management of a displaced simple colles fracture?

Answer 25

MUA

Question 26

management of a displaced, comminuted colles fracture?

Answer 26

MUA
K wiring
ORIF

Question 27

cause of a colles fracture?

Answer 27

FOOSH with extended wrist

Question 28

complications of a colles fracture?

Answer 28

median nerve compression
EPL rupture
CRPS

Question 29

what fracture gets the “dinner fork” deformity?

Answer 29

colles fracture

Question 30

smith fracture management?

Answer 30

ORIF with plate and screws

Question 31

where is a smith fracture?

Answer 31

distal radius

Question 32

bartons fracture management?

Answer 32

ORIF

Question 33

tenderness in the anatomical snuffbox after FOOSH with pain on compression of the thumb?

Answer 33

scaphoid fracture

Question 34

which fracture needs a 4 x ray view?

Answer 34

scaphoid

Question 35

what x ray views are needed for a scaphoid fracture?

Answer 35

lateral
AP
2 oblique

Question 36

how should a suspected scaphoid fracture be treated?

Answer 36

splint the wrist

Question 37

how should an undisplaced scaphoid fracture be treated?

Answer 37

plaster cast for 6-12 weeks

Question 38

how should a displaced scaphoid fracture be treated?

Answer 38

special comrpession screw

Question 39

what metacarpals are treated conservatively if fractured?

Answer 39

3, 4, 5

Question 40

how should an unstable phalangeal fracture be managed?

Answer 40

k wires or small scews