Upper Extremity Ortho Flashcards
What is ORIF?
Open Reduction Internal Fixation
What is CRPPF?
Closed Reduction Percutaneous Pin Fixation
What is DRUJ?
Distal Radioulnar Joint
What is TFCC?
Triangular Fibrocartilage Complex
What are the three most common fracture types?
Transverse
Oblique
Spiral
What types of fractures typically only occur in peds patients?
Green stick
Torus/Buckle
Where is CRPPF most commonly performed?
Fingers
Elbow
Wrist
When is ORIF used?
Screw fixation
Plates and screws
Intramedullary rods
Flexible nails
Most common MOI for clavicle fx
Fall onto shoulder
What position is particularly painful for clavicle fx patients?
Laying flat (they may need to sleep sitting up)
What xray views do you need for clavicle fracture?
AP view
45˚ Cephalic tilt helpful if struggling to view
Most common location for clavicle fx
Middle 1/3 of clavicle
Conservative treatment for clavicle fractures
(Non-displaced, or pediatric patients)
Sling
Figure of 8 brace
Pain management (muscle relaxant, consider ortho referral)
Indications for surgical treatment of clavicle fractures
Displaced
Vascular compromise
Open fractures
More common with adults
Usually ORIF (b/c needs plates)
How long does it take for clavicle fracture treatment
6-12 weeks
MOI for scapula fractures
Rare, involves HIGH ENERGY injury (ie MVA, fall, direct trauma)
Will likely have other associated injuries (evaluate UE, torso, spine)
What xray views do you need for scapular fractures?
AP view
Trans-scapular “Y” view (should not have an angle)
How long does treatment last for scapular fractures?
6 months - 1 year
Conservative - sling/shoulder immobilizer + rehab
Surgery (more common) - articulation surface displacement, impingement syndrome, associated injuries
What is the MOI for Proximal Humerus Fractures
Younger pt - high energy trauma
Older pt - Simple fall (W>M) due to osteoporosis
Clinical presentation of proximal humerus fracture
Severe pain and swelling
Limited ROM
Guarding
Neer Classification is used for what type of fracture?
Proximal humerus fracture
KNOW THIS!!!
Fracture displacements are described based on _____ fragment
Distal
60% of shoulder replacements result from ….
Proximal humerus fractures
What very important things must you rule out when evaluating humerus fractures?
Radial nerve injury
• look for wrist drop
• “vroom vroom”
Associated forearm fx —> “floating elbow”
What xray views do you need for numeral shaft fractures?
AP and AP with external rotation (b/c lateral hard to get)
What is the most common cause of pathological numeral shaft fractures?
Benign unicameral bone cyst (UBC)
Suspect in peds patient with bubbly fx in this location
