L6: Wrist, Upper Limb and Elbow Trauma

Question 1

Normal Carpal Bones

Answer 1

Question 2

What is this sign called?

What does it indicate?

Answer 2

Question 3

What is this Injury?

How Is it treated?

Answer 3

Scaphoid Fracture

If a scaphoid injury is suspected and X-rays shows no fracture.

• Treat anyway. Patients are immobilised at the wrist and followed up clinically in 10 days
• Repeat X-rays OR perform MRI

Question 4

What is this injury called?

How does it manifest Radiologically?

Answer 4

Question 5

What is this injury called?

How does it manifest Radiologically?

Answer 5

Question 6

Injury resulting in distal radius fracture and dorsal displacement of wrist?

Answer 6

Colles Fracture

Question 7

Injury resulting in Distal radius fracture and volar displacement of the wrist?

Answer 7

Question 8

Not complete cracks => Cortical break and buckling

Answer 8

Greenstick Fracture

Question 9

Fracture through Epiphyseal Plate

Answer 9

Salter Harris Fracture

Question 10

Normal Elbow X-Ray?

Answer 10

Anterior humeral line should pass through center of capitulum

Question 11

Name of injury resulting in Fracture of Radius and Dislocation of Ulna

Answer 11

Galeazzi Fracture

Mainly children (peak incidence 10 years)

Galeazzi Type I : dorsally displaced distal radius

Galeazzi Type II : volar displacement

Question 12

Types of Galeazzi Fracture and their Casues?

What is often injured in a Galeazzi Fracture?

Check for nerve damage?

Answer 12

Interosseous membrane damaged because of overlap of radial bones

OK Sign with hand to check medial nerve (anterior interosseous nerve) damage

Question 13

Name of injury resulting in Ulna Fracture and Radial Head Dislocation

Answer 13

Monteggia Fracture-Dislocation

Question 14

Distinguish between Galeazzi and Monteggia Fractures?

Answer 14

GRUesome MURder

• Galeazzi Radius Fracture, Ulna Dislocation
• Monteggia Ulna Fracture, Radial Head Dislocation

Question 15

What does this show?

Answer 15

Fractured Ulnar + Radial head displacement = Monteggia Fracture

Question 16

Age of Appearance of Ossification Centers of the Elbow?

Answer 16

(CRITOE)

(AGE 1) Capitulate

(AGE 3) Radial head

(AGE 5) Internal Medial Epicondyle

(AGE 7) Trochlea

(AGE 9) Olecranon

(AGE 11) External (lateral) epicondyle

Question 17

Significance of fat pads in diagnosing elbow injury?

Answer 17

Damage to the elbow => accumulation of blood => displaces fat pads upwards=> Sail Sign on XRAY

Question 18

Sign apparent on X-Ray for Fractured Elbow/Humerus

Answer 18

Sail Sign

Question 19

Most common cause of an elbow joint effusion in children?

Answer 19

Supracondylar Fracture

Question 20

Complications of Supracondylar Fracture of the Humerus?

Answer 20

• Malunion leading to Cubitus Varus (deviation of elbow towards midlin)
• Volkmann contracture: Damage to vasculature => ischemic damage
• Damage to nerves (ulnar is most common)
• Loss of trochlear ossification centre (fish-tail deformity)

Question 21

Answer 21

Varus Deformity

Caused by Supracondylar Fracture of the Humerus

Question 22

Answer 22

Volkmann’s Ischaemic Contractures

Caused by Supracondylar Fracture of the Humerus

Question 23

Nerves/Artery of the Elbow

Answer 23

Question 24

Tests to check Radial Nerve Motor/Sensory Function following supracondylar fracture of the humerus?

Answer 24

Question 25

Tests to check Median Nerve Motor/Sensory Function following supracondylar fracture of the humerus?

Answer 25

Question 26

What is this deformity a sign of?

Answer 26

Fishtail Deformity: Trochlea Site Never Develops

Loss of trochlear ossification centre, caused by Supracondylar Fracture of the Humerus

Question 27

Muscles composing the Floor of the cubital fossa?

Answer 27

Formed by the brachialis muscle proximally and the supinator muscledistally

Question 28

Answer 28

Question 29

Relationship of brachial artery to the humerus?

Answer 29