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NMSKI > Shoulder Fractures > Flashcards

Shoulder Fractures Flashcards

1
Q

joints around shoulder

A

glenohumeral joint
Acromioclavicular joint
Sternoclavicular joint
Scapulothoracic joint

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2
Q

connective tissue in shoulders

A

glenoid labrum
ligaments
bursae

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3
Q

causes of fractures in clavicle

A

Direct blow on the point of the shoulder

fall on outstretched hand

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4
Q

site of injury in clavicle

A 
junction mid/outer 1/3
Middle 1/3
outer 1/3
more less acromioclavicular joint injury 
\+/- Sternoclavicular joint injury
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5
Q

examinations made in clavicle fractures

A

Check for tenting
May be an impending open fracture
Check for an neurovascular deficits (brachial plexus injury)

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6
Q

what vessel should we be careful about when looking at clavicle fracture

A

Subclavian vessels proximity to clavicle

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7
Q

treatment of undisplaced clavicle fractures

A

Broad arm sling up to 3/52 or Figure of 8 bandage
Must provide support for weight of the arm
Commence ROM ex at 3-4 weeks

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8
Q

treatment of displaced clavicle fractures

A

ORIF + Sling.

Longer period of immobilisation

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9
Q

types of reduction needed for middle third clavicle fracture

A

no reduction

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10
Q

types of reduction need for lateral third clavicle fracture

A

undisplaced - no reduction

displaced - refer to nearest orthopaedic service on call

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11
Q

type of reduction needed for medial third clavicle fracture

A

undisplaced - no reduction

displaced -refer to nearest orthopaedic service on call

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12
Q

immobilisation method for middle third and duration for clavicle fracture

A

broad arm sling for 2-3 weeks or until comfy

regular analgesia

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13
Q

immobilisation method for lateral third and duration for clavicle fracture

A

broad arm sling to support limb for 4 weeks or until comfy

regular analgesia

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14
Q

immobilisation method for medial third and duration for clavicle fracture

A

broad arm sling to support limb

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15
Q

complications of clavicle fractures

A

Comminution with separation (bone is broken into multiple pieces)
Skin penetration (open fracture)
Associated nervous and vascular trauma/damage (brachial plexus or supraclavicular nerves)
Nonunion after several months (3–6 months, typically)
Deformity
Displaced distal third fractures (high risk of nonunion)

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16
Q

causes of AC joint injury

A

Blow to shoulder downward force e.g. rugby or hockey

Grade 1 – 6 (ref Shoulder STI lecture

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17
Q

examination of AC joint injury

A

Tenderness
Palpable step
Arm may look longer
AP X-Ray

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18
Q

treatment for stable AC joint injury

A

Grades 1-3
Sling 4 - 6/52
Commence ROM after this

19
Q

treatment for unstable AC injury for grades 4-6

A

Grades 4-6
ORIF screw / realign
+ Sling / body-bandage x 4 - 6 weeks

20
Q

types of SC joint dislocation

A

anterior and posterior dislocation

21
Q

anterior dislocation of SC joint causes

A

Uncommon
Fall on hand / shoulder forces inner end clavicle forward
High energy force

22
Q

treatment of anterior dislocation of SC joint

A

Reduce
Sling 2 - 3 weeks
+/- ORIF + brace 4 - 5 weeks

23
Q

posterior dislocation of SC joint

A

more serious

24
Q

treatment of posterior dislocation of SC joint

A

ORIF

25
Q

Cause of fracture of scapula

A

Usually direct violence

26
Q

location of fractures on scapula

A

Spine
Coracoid
Acromion
Body

27
Q

treatment for fracture of scapula

A

Usually broad arm sling for 2-4 weeks

Followed by ROM/physio

28
Q

common location of fracture in proximal humerus

A

Neck of humerus

Avulsion # Greater Tuberosity

29
Q

causes of avulsion greater tuberosity humerus

A

Forceful avulsion of supraspinatus tendon

Fall on shoulder in older patients

30
Q

treatment for avulsion greater tuberosity humerus in undisplaced injury

A

Support (Collar and Cuff) x 2-3 weeks

Early mobilisation

31
Q

treatment for avulsion greater tuberosity humerus in displaced injury

A

ORIF

Collar and Cuff for 4-6 weeks

32
Q

causes of fracture on surgical neck of humerus

A

fall on outstretched hand

33
Q

categorising fracture of surgical neck of humerus

A

Stable / unstable

Displaced / impacted

34
Q

complications of surgical neck of humerus

A

Non-union

Damage blood vessel / nerve

35
Q

management of surgical neck of humerus fracture - Stable

A

Can be impacted or non-impacted
Non-impacted
Collar + cuff x4 - 6 weeks
Mobilisation after this

36
Q

management of surgical neck of humerus fracture - impacted

A

Collar + cuff x 2/52

Mobilisation after 2 weeks

37
Q

management of surgical neck of humerus fracture - unstable/displaced

A

ORIF
Collar + cuff x4 - 6 weeks
Mobilisation after this

38
Q

causes of fracture of shaft humerus

A

Direct violence

Indirect violence e.g. Fall

39
Q

types of fracture of shaft humerus

A

Spiral
Transverse
Pathological

40
Q

complications associated with fracture of shaft humerus

A

Radial nerve palsy
Mal-union) – proximal fragment abducted (Deltoid ‘pull’)
Non-union

41
Q

radial nerve palsy

A

wrist drop
Weak/absent wrist and finger extension
Reduced /absent sensation dorsum of wrist+/- forearm

42
Q

management of radial nerve palsy

A 
May take number of weeks to recover 
Maintain passive ROM
Splinting (dynamic or resting splint) 
Sensory awareness 
Strengthening once recovery occurring
43
Q

conservative treatment of shaft humerus fracture

A

Surrounding musculature stabilise / weight of arm
U slab / hanging cast
+ collar + cuff
If position unacceptable may require ORIF

44
Q

ORIF treatment of shaft humerus fracture

A

Plate and screws
Intramedullary (IM) nailing
Minimally invasive percutaneous osteosynthesis (MIPO).

NMSKI (38 decks)

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