Fractures

Question 1

Fracture of the surgical neck of the humerus

Answer 1

Can damage the axillary nerve and posterior circumflex artery
Causes paralysis of the deltoid and teres minor, loss of abduction of the arm.
Loss of sensation at the regimental badge region

Question 2

Mid-shaft fracture of the humerus

Answer 2

Can damage the radial nerve and profunda brachii
Causes paralysis of the extensor muscles and therefore cause ‘wrist drop’
Sensory loss over the dorsal surface of the hand.

Question 3

Distal humeral fracture

Answer 3

Supraepicondylar fracture can damage the brachial artery and medial/radial/ulnar nerves.
Causes Volkmann’s ischaemic contracture where the flexor muscles are shortened

Medial epicondyle fracture can damage the ulnar nerve, causing ulnar claw (hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints)
Sensory loss over the medial 1 1/2 fingers over the palmar and dorsal surfaces.

Question 4

Monteggia’s fracture

Answer 4

Proximal shaft of the ulna is fractured, the head of the radius dislocates anteriorly

Question 5

Galezzi fracture

Answer 5

Distal radius is fractured with dislocation of the ulna. Can damage the radial/posterior interosseus nerve.
Loss of pinch mechanism as flexor pollicis longus and fexor digitorum profundus are paralysed
Wrist drop

Question 6

Scaphoid fracture

Answer 6

Causes pain and tenderness in the anatomical snuffbox
Blood supply to the proximal part of the bone which can cause avascular necrosis.
If undiagnosed, are likely to develop wrist arthritis.

Question 7

Colles fracture

Answer 7

Fracture to the distal radius with posterior displacement

Question 8

Smith’s fracture

Answer 8

Fracture to the distal radius with anterior displacement

Question 9

Boxer’s fracture

Answer 9

Fifth metacarpal base neck fracture.

Distal part is displaced posteriorly producing shortening.

Question 10

Lunate fracture

Answer 10

Causes hyperextension at the wrist

Can be associated with median nerve damage.

Question 11

Bennet’s fracture

Answer 11

First metacarpal base fracture extending into the carpometacarpal joint.
Caused by hyperabduction of the thumb.