Fractures

Question 1

define Colle’s fracture

Answer 1

a fracture occurring upon a fall on an outstretched wrist

• occurs mainly in older osteoporotic women

Question 2

result of Colle’s fractures

Answer 2

distal radial fracture

dorsal displacement of distal fragment

Question 3

clinical features of Colle’s fractures

Answer 3

swelling of distal radius

‘dinner fork’ deformity of the wrist

Question 4

indications for surgery in Colle’s fractures

Answer 4

intraarticular extension of fracture
significant angulation
unsatisfactory closed reduction
loss of height on impaction

Question 5

management of Colle’s fractures

Answer 5

manipulation to reduce fracture (i.e. brace/cast)

immobilisation 3-4wks

Question 6

surgical management of Colle’s fractures

Answer 6

open reduction and internal fixation with plates and screws

Question 7

complications of Colle’s fractures

Answer 7

median nerve injury
carpal tunnel syndrome
frozen shoulder
mal/non-union

Question 8

define Smith’s fractures

Answer 8

fractures of distal radius associated with volar angulation of distal fracture fragments

occur due to fall onto flexed wrist or direct blow to back of wrist

Question 9

result of Smith’s fractures

Answer 9

extra-articular transverse fracture through distal radius (Type I)

intra-articular oblique fracture (Type II)

Question 10

treatment of Smith’s fractures

Answer 10

closed reduction and cast application

Question 11

surgical management of Smith’s fractures

Answer 11

operative fixation (ORIF)

Question 12

define Monteggia fractures

Answer 12

fractures involving the proximal 1/3rd of the ulnar shaft and anterior dislocation of the radial head at capitellum

Question 13

define Galeazzi fractures

Answer 13

fractures involving the distal 1/3rd of the radial shaft and dislocation of the radio-ulnar joint

Question 14

management of unstable Galeazzi and Monteggia fractures

Answer 14

in adults: open repair

in children: manipulation under anaesthetic with a cast

Question 15

define clavicle fractures

Answer 15

a fracturing of the clavicle (often in the middle 1/3rd) that occurs either due to a fall onto an outstretched hand or direct shoulder trauma

Question 16

clinical features of a clavicle fracture

Answer 16

pain in the clavicle/shoulder
inability to move the shoulder
deformity of the area

Question 17

indications for immobilisation in a sling in clavicle fractures

Answer 17

simple fracture on XR
minimal displacement
no breaks in skin
no evidence of neurovascular compromise

Question 18

management of uncomplicated clavicle fractures

Answer 18

analgesia
immobilisation in sling for 2wks
refer to physiotherapy once sling removed to mobilise arm