Lecture 16 - UE Fractures Flashcards
clavicular # - MOI, where most commonly injured, and medical/surgical management
- reading p 2-3
scapular # - MOI, location, medical/surgical management
- reading p 4
proximal humerus # - types, what constitutes a displacement?, medical and surgical management
- reading p 4-5
humoral shaft # - describe 3 locations and their displacement patterns
- reading p 6
humoral shaft # - medical/surgical management and period of immobilization
readin p 6-7
what are the types of distal humerous #?
- reading p 7-8
medical/surgical management of distal humerus #
- reading p 8
what is an Essex-Lopresti lesion
Essex-Lopresti lesion is a specific injury involving a longitudinal disruption of the interosseous ligament of the F/A, usually accompanied by a radial head Fx and/or dislocation, and an injury of the distal R/U joint.
what muscles do proximal forearm #s involve? what is the typical MOI?
Any fracture of the olecranon will affect the triceps mechanism, interfering with active elbow extension. Any fracture of the radial head will interfere with, or cause pain with, forearm pronation and supination.
- reading p 9
medical and surgical management of proximal forearm #? cast used and imobilization period?
- reading p 9
what is a nightstick fracture?
what is a Monteggia fracture
what is a Galeazzi (a.k.a. Piedmont) fracture?
MOI and medical/surgical management of radial and ulnar shaft #s - and period of immobilization
- reading p 10-11
Distal Radius and Ulna Fx: Medical / Surgical Management - period of immobilization, MOI
- reading p 11-12
what is a colles #?
what is a Smith’s Fracture?
what is a Barton’s Fracture?
describe a # of radial or ulnar styloid process
what are the most common types of carpal bone #s and MOI?
Fractures of the carpal bones are most commonly associated with FOOSH injury, or some similar mechanism. The scaphoid accounts for between 50-80% of carpal fractures, with the Triquetrum, Trapezium and Lunate (in descending order) also occasionally involved. A fracture of the other carpal bones is exceedingly rare.
describe scaphoid #s - what findings lead to clinical impression?
- reading p 13
scaphoid # - medical/surgical management - period of immobilization
- reading p 13-14
medical/surgical management of other carpal #s (non-scaphoid)
reading p 14
what is a Bennett Fracture?
what is a boxers #?
metacarpal and phalangeal #’s - MOI, surgical management and associated injuries
- reading p 14-15
what are the 5 diagnostic P’s?
Pain, Paralysis, Paresthesia, Pallor, Pulselessness
UE # management - general principles
–Early fixation
–Early mobilization
–Early range of motion
UE # rehab guided by… ?
Rehab guided by:
–Medical / surgical management (Structures affected, Surgeon’s guidelines)
–Functional goals
–Detailed functional assessment
General PT Management for fractures
GROUP Q:
- What are the advantages of performing AAROM exercises…
a) …rather than PROM?
b) …rather than AROM? - Under what conditions would you opt for PROM exercises rather than AAROM exercises?
PT management clavicular #
class Q:
How might a deformity following the healing of a clavicular fracture affect long-term function?
Scapula Fx - PT management
Greater Tuberosity Fx - PT Management
Unstable Fx:
–Rehab will begin ͞p ~4 wks
–Then, follow same progression as non-displaced #
*Watch signs of shoulder stiffness (frozen sh) throughout rehab
Proximal Humerus Fx – PT Management
•Refer to protocol posted on MyCourses for an example of the general PT management of proximal humerus fracture for non-operated vs operated cases
Humeral Shaft Fx – PT management
Distal Humerus Fx - PT management
ORIF interventions and/or Transcondylar Fx
–Early elbow ROM (as soon as patient tolerate mvt)
Supracondylar Fx (conservative)
–Posterior splint immob for ~6 wks
–Begin AA-AROM ͞p 1-2 wks (remove & replace splint)
Capitulum and/or Trochlea Fx (conservative)
–Posterior splint immob for ~3 wks
–Elb AA-AROM ex’s ͞p immobilization
Med Epicondylar Fx (conservative):
–Immob 10-14 days
–Elb AA-AROM ex’s ͞p immobilization
Lat Epicondylar or Supracondylar Process Fx:
–Symptomatic immob + early motion
Proximal Forearm Fx – PT Management (olecranon)
Early motion is key***
–Elbows will stiffen quickly
–Some loss of ROM still expected (~ -10° ext)
Proximal Forearm Fx – PT Management (radial head)
Early motion is key***
–Elbows will stiffen quickly
–Some loss of ROM still expected (~ -10° ext)
Nightstick Fx - PT Management
Monteggia Fx - PT Management
Galeazzi Fx - PT Management
Distal Radius and Ulna Fx – PT management
group question:
85 y.o. ♀ s/p R Smith’s Fx 6 weeks ago, immobilized in a long-arm cast with elbow at 90o x 6 weeks, cast removed yesterday.
What impairments would you expect the patient to have at this point?
Scaphoid Fx – PT Management
Other Carpal Fx (not scaphoid) – PT Management
–Begin once clinically healed
–Follow general PT management principles
Metacarpal & Phalangeal Fx – PT Management
