UE Fracture Flashcards
where on the clavicle are you most likely to fracture?:
middle third (80%)
common deformity from clavicular # involves the medial part moving ___ and the lateral part moving ___
up
down
what is the most common way to treat a clavicular #?
sling and swathe for 4-6 weeks
how are scapular #s usually treated?
sling and swathe for at least 2-3 weeks
when are proximal humerus #s considered displaced?
if the fragment’s moved more than 1cm or angled farther than 45degrees
note 85% prox hum #s are undisplaced
describe the three typical displacements of humeral shaft #s and which muscles pull them this way
surgical neck - proximal pulled into ABD and ER by rotator cuff, distal pulled into ADD by pecs
below pecs above delts - prox pulled into ADD by pecs, distal pulled ABD by delts
below delts - prox pulled ABD by delts, distal pulled ADD by biceps/triceps
how are the vast majority of shaft #s treated? even ones 3cm off and 30 degrees rotated?
conservative with coaptation splint or hanging cast
how are distal humerous #s usually managed?
splinting - posterior elbow for 90 degrees, posterior long arm for slight flexion
what is standard management of a olecranon #? what about a radial head #?
olecranon - long arm cast at 45 or 90 flexion for 3 weeks if non-displaced, if displaced a posterior elbow splint following fixation
radial head - simple sling if non-displaced, surgery if displaced
what is a nightstick #? how is it usually managed?
ulnar shaft # - sugar tong splint for 7-10d, then sling for 8wks
what is a monteggia #?
prox 1/3 ulna # with dislocation of radial head
what is a galeazzi #?
prox 1/3 radius # with dislocation of distal radioulnar jt
how are most F/A #s managed?
long arm cast at 90 degrees
what is the most common type of distal F/A #?
colles - distal radius # with dinner fork deformity (distal part of radius dorsal)
what type of # gives a garden spade deformity?
Smith’s #
how long are F/A #s usually immobilized?
if a stable fixation of radial head, how soon can one start AAROM?
4-6wks immobilized
if stable, no pron/sup for 3 weeks, AAROM everywhere else ok
which part of the schaphoid is most prone to avascular necrosis?
the proximal part
pain (in general or when resisting pronation/supination in handshake position), tenderness to palpation in which region of the wrist can indicate a scaphoid #?
what about axial compression of which metacarpal?
anatomical snuff box, first metacarpal
how long will a proximal scaphoid # need to be immobilized for?
12-24 weeks!!
what causes most metacarpal/phalangeal #s?
punching or hitting
what is mallet finger?
cannot extend DIP
what are the 5 diagnostic Ps?
pain pallor pulseless paralysis paresthesia
for an undisplaced greater tuberosity #, what 3 things does one have to keep in mind and when can STR training start?
no ER or ABD AA-ROM for 6 weeks, PROM can start after about a week, and do not push EOR in IR
can start isometrics at 6-8wks, RT at 12wks
are there any contraindications to humeral shaft # treatment once ok’d by MD?
no
how soon can a stable metacarpal/finger # be doing AA-ROM?
within 72 hours to try and prevent contraction
what is contraindicated with olecranon # for first 6-8 once out of cast?
can do PROM only except flexion up to 90 degrees but not beyond
when can a supracondylar # patient be given AAROM?
after 1-2 wks (remove and replace splint)
