Injuries

Question 1

Nightstick fracture

Answer 1

Ulnar shaft fracture

Defensive injury

Question 2

Colle’s fracture

Answer 2

Fracture of distal radius (can be ulna also)

Usually from falling on outstretched arm

Question 3

Nursemaid’s elbow

Answer 3

radius dislocates from annular ligament

Question 4

Volkman’s ischemic contracture

Answer 4

Damage to brachial a in cubital fossa
When muscle is deprived of blood, tends to shorten
Forearm tightness

Question 5

T1 nerve root damage

Answer 5

loss of intrinsic hand muscles

Extension at MCP joints, flexion at IP joints

Question 6

Midshaft humeral fractures

Answer 6

Damages contents of triangular interval

Deltoid pulls upper fragments laterally, biceps/triceps pull lower fragment proximally

Question 7

Cubital tunnel syndrome

Answer 7

Ulnar N injury

Numbness and tingling of medial palm and last 1 1/2 digits

Question 8

Pronator syndrome

Answer 8

Compression of Median N between heads of the pronator teres

Pain in proximal forearm, weakness in flexing fingers/wrist, decreased sensation in lateral palm and digits

Question 9

Supracondylar fracture

Answer 9

Can damage median nerve
Loss of thumb function, numbness in medial palm, weak flexion of digits 2-3
Causes Hand of Benediction

Question 10

Rupture of biceps tendon

Answer 10

Proximal rupture: Usually from long head tendonitis

Distal rupture: rare, occurs during forceful contraction

Question 11

Musculocutaneous N injury

Answer 11

From trauma to axilla or compression from coracobrachialis

Weakness of anterior comparment, numbness in lateral forearm

Question 12

Long Thoracic N injury

Answer 12

Hard to lift arm above 90 degrees
Scapular winging
Vulnerable during breast cancer surgery when removing axillary lymph nodes

Question 13

Ulnar Nerve Palsy

Answer 13

Ulnar claw - MCP 4 and 5 become hyperextended with flexed IP joints
PASSIVE sign

Question 14

Median Nerve Palsy

Answer 14

Sign of the benediction - inability to flex lateral 3 digits
Simian hand - wasting of thenar eminence, thumb adducted and laterally rotated
Inability to make “OK” - impingement of anterior interosseous

Question 15

Radial Nerve Palsy

Answer 15

Lesion in axilla, forearm, wrist
Saturday night palsy or “Handcuff palsy”
Weakness in triceps, loss of all posterior muscles of the forearm, numbness over dorsum of hand

Question 16

Klumpke’s Palsy/Paralysis

Answer 16

Strap hanger's syndrome
Lesion C8-T1
Impacts ulnar and median
Loss to intrinsic hand muscles, weakness/loss of extrinsic hand flexors
Hand in full claw position

Question 17

Erb’s Palsy

Answer 17

Lesion of C5-C6
Impacts esp axillary, musculocutaneous, suprascapulars
Paralysis of abductors/lateral rotators of shoulder, elbow flexors, supinators
Waiter’s tip

Question 18

Suprascapular N impingement

Answer 18

under transverse ligament/in suprascapular notch

Question 19

Carpal tunnel syndrome

Answer 19

impingement of Median N
Numbness of thumb and palmar surface/tips of 3.5 digits
Wasting of thenar muscles

Question 20

Ulnar nerve impingement sites

Answer 20

Medial epicondyle (numb pinky)
Cubital tunnel
Ulnar canal in the wrist (Guyon canal)