Upper extremity

Question 1

Clavicle fracture

Answer 1

Proximal fragment is elevated and distal fragment is depressed due to muscular pull.

Question 2

Anterior dislocation

Answer 2

• Most common (95%)
• Risk for axillary nerve damage
• Patient holds arm in slight abduction and external rotation

Question 3

Posterior dislocation

Answer 3

• Rare
• Associated with seizure and electrocution
• Patient holds arm in adduction and internal rotation

Question 4

Humerus fracture

Answer 4

May lead to nerve damage if fractured:
- Proximally - axillary
- Mid-Shaft - radial
- Distally - median/ulnar

Treatment: coaptation splintif uncomplicated.

Question 5

Galeazzi

Answer 5

• Distal radius fracture
• Ulnar dislocation

Question 6

Monteggia

Answer 6

• Proximal ulnar fracture
• Radius discloation

Question 7

Nightstick fracture

Answer 7

Ulnar shaft fracture. Usually caused after self-defense

Question 8

Colles fracture

Answer 8

• Results from a fall onto an out-streched hand (FOOSH) that is in dorsiflexion.
• Normally seen in elderly (osteoporosis) and children.

Question 9

Scaphoid fracture

Answer 9

• Most commonly fractured carpal bone
• Results from FOOSH
• May take 2 weeks for x-ray to show fracture you can assume that a fracture is present if there is tenderness in anatomic snuffbox

Question 10

Boxer´s fracture

Answer 10

• Fracture of the fifth metacarpal neck
• Caused by forward trauma of a closed fist
• (Thumb spica cast)

Question 11

DeQuervain tenosynovitis

Answer 11

• New parent holding infant with outstreched thumb or frewuent use of handheld device
• Pain on Finkelstein test (flexing thumb across palm and placing wrist in ulnar deviation)