Orthopaedic Surgery

Question 1

A 10yr old girl falls and fractures her radius and ulnar, she is put in an above elbow
plaster and is educated about the complications of compartment syndrome. What is the
first sign of compartment syndrome?

A. white hand
B. inability to straightened her fingers.
C. severe pain.
D. numbness in her fingertips.
E. inability to feel a pulse.

Answer 1

C.
The first symptom of compartment syndrome is pain. Loss of function and decreased pulses are late signs. Paraesthesia (altered sensation e.g. pins and needles) in the cutaenous nerves of the affected compartment is another typical sign.

Look up: compartment syndrome, nerves distribution of the upper limbs.

Question 2

A young man presents post a motorcycle accident with a broken clavicle (shown x-ray).
What is the most likely complication of this fracture?

A. Axillary vein laceration
B. Puncture overlying skin.
C. C. Axillary nerve impingement.
D. D. Mal-union of the fracture.
E. E. Axillary artery laceration

Answer 2

Answer would also depend on X-ray given.

Complications of fractures:

• Delayed union or non-union: a failure to show clinical or radiographic progression of healing after 4-6 months.
• Fractures of the middle third of the clavicle have been associated with injuries to the neurovascular bundle.
• Brachial plexus compression resulting from hypertrophic callus formation
• Poor cosmetic appearance
• Post-traumatic arthritis

https: //lifeinthefastlane.com/minor-injuries-005/
http: //emedicine.medscape.com/article/92429-overview#a6