MSK Flashcards
What nerve injury must you r/o in humeral shaft fractures?
Radial
- check deltoid sensation, brachial plexus injury
What nerves can be injured in proximal humerus/humeral head fractures?
Radial, axillary
- brachial plexus injuries
What is a common clinical manifestation seen in someone w/ an injured radial nerve?
“wrist drop”
- Radial nerve supplies the extensor muscles
- Arm usually held in adducted position too
Humeral fractures: What is the MOI?
FOOSH, direct trauma
How do you treat humeral fractures?
Sugar tong splint
Coaptation sling
Ortho fu 24-48hr
What is the MC fractured bone in children, adolescents, and newborns?
Clavicle
Clavicle fractures: What is the MOI?
Mid-high energy impact
- In children < 2, suspect child abuse
- MC in males
Clavicle fractures: What clinical manifestations can be seen?
pain w/ ROM
deformity
+/- “tenting” of skin
may hold arm against chest
What are complications of clavicle fractures?
pneumo or hemothorax
coracoclavicular ligament disruption
brachial plexus injury
How do you manage clavicle fractures?
Mid 1/3 –> arm sling x 4-6 wks in adults, figure of 8 sling for kids
Proximal 1/3 –> ortho consult
AC joint dislocation: What is the MOI?
direct blow to adducted shoulder
AC joint dislocation: what clinical manifestations are seen?
pain w/ lifting arm
+/- deformity
How do you manage AC joint dislocations?
Brief sling immobilization, ice, analgesia, ortho fu
Type III might need surgery!
What are the classes of AC joint dislocation?
I: normal cxr, ligamental sprain
II: slight widening (AC ligament ruptured)
III: significant widening (rupture of both AC & CC ligaments)
IV: class III + displacement of clavicle into trapezius
V: class IV + disruption of clavicle attachments
Anterior GH shoulder dislocation: What is the MOI?
blow to abducted, externally rotated arm that is extended
What are the clinical manifestations seen in anterior GH dislocations?
arm abducted, externally rotated
“squared off shoulder”
What type of GH dislocation is MC?
Anterior
How do you diagnose an anterior GH dislocation?
Axillary & “Y” view
Hill-Sachs lesion: Groove on humeral head
Bankart lesion: glenoid inferior rim fx
Posterior GH dislocation: What is the MOI?
forced adduction, internal rotation
What are posterior GH dislocations MC a/w?
Seizures, electric shock
What must you rule out in anterior GH dislocations?
Axillary nerve damage (pinprick sensation over deltoid)
How do you treat GH dislocations?
Reduction
What is the MCC of shoulder pain if > 40yo?
Rotator cuff tear
Rotator cuff injuries: What is the MOI?
chronic erosion (overhead movements)
+/- trauma
Common in athletes or laborers
