ortho Flashcards
anterior glenohumeral shoulder dislocation
abducted arm and externally rotated squared off shoulder axillary and y view hill sachs: groove on humeral head bankarlesion: glenoid inferior rim fracture
posterior shoulder dislocation
MC associated with seizures electric shock
adducted internally rotated
rotator cuff injuries
SITS: supraspinatus, infraspinatus, teres minor, subscapularis)
common in athelese with repetitive overhead movements
supraspinatus is MC
anteroir deltoid pain with decreased ROM especially with overhead activities, external rotation or abduction
empty can test: supraspinatus strength test
rotator cuff impingement tests
hawkin’s test: elbow/shoulder flexed at 90 degrees with sharp anterior shoulder pain with internal rotation
drop arm test: can’t hold arm above shoudler level or severe pain when slowly lowering the arm
neer test: arm fully pronated and thumbs downwith pain during forward flexion)
acromioclavicular joint dislocation
pain with lifting arm, unable to lift arm at shoulder, +dformity at ac joint
type I: just ac joint weakneed
type 2: ac rupture
type 3: ac rrupture and coracoclavicular lig ruptured too
humeral head fractures or proximal humeral fractures
CHECk DELTOID SENSATION- to rule out brachial plexus or axillary nerve injuries
Humeral SHAFT fractures
must rule out radial nerve injury- this injury may cause wirst drop
clavicle fracutre
tenting of skin, most common fractured bone in children adolescends and newborns during birth
figure of eight sling in children
proximal 1/3 –> ortho consult
adhesive capsulitis
frozen shoulders
(DM and hypothyroid)
shoudler pain/stiff for more than 18.24 months- decreased ROM especially external rotation, SIFF-pain cycle- pain worse at night
RHEAB, antiinflammatories, surgery
thoracic outlet syndroem
idiopathic copressions of brachial plexus, s
loss of radial pulse with head rotated to affected side
supracondylar huermus fracture
swelling, tenderness at the elbow, mc in children
displaced anterior fat pad sign or posterior fat pad sign
in children if psoterior or anterior fat pad- radial head fracture
complications: MEDIAN NERVE AND BRACHIAL ARTERY INJURY- volkmann ischemic contracture
RADIAL NERVE INJURY!
if displaced: ORIF!!
radial head fractures
inability to fully extend the elbow FOOSH posterior fat pad sign or displaced anterior fat pad sling, long arm if non-dsplaced if displaced- orif
suppurative flexor tenosynovitis
staph aureus MC- infection of the flexor tendon synovial sheath of the finger finger held in flexon lenght of tendon sheath is tender enlarged finger extension of finger causes pain
olectranon fracture
ulnar nerve dysfunction- inability to extend the elbow
ulnar shaft
nightstick fracture
nondistal 1/3— short arm cast
nondisplaced mid proximal 1/3: long arm cast
dispalaced: ORIF
monteggia fracutrue
proximal ulnar shaft fracture with an anterior RADIAL HEAD DISLOCATION!!!
RADIAL NERVE INJURY!!!
ORIF!
galeazzi
mid-distal radial shaft fracutre with DISLOCATION of DRUJ (distal radioulnar joint)- FOOSH
unstable- needS ORIF
nursemaid’s elbow
pessure on radial head with supination and flexion
lateral epicondyltisis- tennis elbow
lateral elbow pain - wrist extension and FORARM pronation against resistance- gives pain!!
medial epicondylitis
golfers elbow: WRIST flexion against RESISTANCE
elbow dislocation
posterior is MC type
r.o brachial artery, median, ulnar, radial nerve injury
scaphoid fracture
foosh anatomical snuffbox tenderness incidence of avascular necrosis if you miss this!! thumb spica!! displaced: ORIF
colles fracture
FOOSH With wrist extension-dinner form deofrmity - on ap colles and smith look same
EPL tendon rupture MC
sugar tong splint//cast!
dorsa/posterior angulation
smith fracture
ventral/anterior angulation- mc foosh with wrist FLEXION