upper extremity squirm Flashcards
Classification of clavicle fractures that are lateral third?
Allman
Group 2 type 2 is operative
1. lateral to conoid
2a is medial to conoid and trapezoid so displaced
2b is torn conoid
3 is intraarticular into joint and table. arthritis risk
Type IV and V A/c separation
4 is posterior and into trap.. V is more than 100% with displacement, skin tenting
VI is conjoined tendon
Compartment syndrome sign for scapula?
Comolli sign
Corocoid classifcaion
1 is proximal to cozrococlavicular ligament, 2 is TIP
Glenoid classification
Ideberg 1a anterior rim, 1b posterior rim 2 is inferior/lateral 3 is superior 4 is medial exit fracture 5 is mix 6 is comminuted
OR for glenoid when?
25% or more involvement or 5 MM step off. CONSIDER 3d econ
When do you operate on scapula neck?
40 degrees translated
Acromion fracture classification
1 nondisplaced
2 opening of subacromial space
3 closure of space. THREE IS OPERATIVE
Classification of scapulothoracic dissassocation
Mild medium hot. 1 cm neuro intact. 2 a vascular 2 b neuro issue 3 is both neuromuscular out
HAGL? Bankhart? Hillsachs? Who gets rotator cuff tear? What is hillsachs view
Humeral avulsion of glenohumeral ligaments.
labral tear, or fracture of glenoid if bony, hillsachs is humeral head fracture.
Hilsachs view is internal rotation to see posteriolateral cortex
blood supply humeral head
Used to say anterior circumflex to arcuate, but now say posterior humeral circumflex contributes a lot
parts of humerus definition
45 degree angle or 1 cm separation unless greater tuberosity and it is 5 mm.
Lesser tuberosity: assume posterior dislocation until proven otherwise.
Proximal humerus malunion classification
2 classifications
Beredjiklian
1. tuberosity off 1 cm
articular surface incongruent
3 articular surface malalignmed
boileau 1 necrosis or impaction 2 chronic dislocation 3 surgical neck nonunion 4 malunion of tuberosity is SEVERE
Where is radial nerve?
14 cm from lateral epicondyle, 20 from medial
Acceptable humerus shaft allignment
20 degrees ap, 30 varus/valgus and 3 cm shortening
Nonunion risk increaesed in proximal third
Distal humerus intercondylar fracture classification
Risenburg
1 non displaced
II slight displacement without rotation
III rotated
IV severe comminution
Tx is ORIF or Bag of Bones
AO distal humerus classiation
A extreaarticular
B single column
C both column
What is concern of Jupiter H type?
Trochlea at risk of AVN (Jupiter is 2 column distal humerus fractures)
Olecrenon schatzker
transverse transverse with dip oblique comminuted oblique distal Comminuted?
Radial head classification
Mason - 4 types Nondislaced angulatedmight block III comminuted and blocked 4 with a dislocation
fun fact LCL injured with 80% of them
OR for radial head?
2 mm displaced of 25% of articular surface
Insertion of mcl most important bundle?
Anterior bundle on sublime tubercle (Anterior medial facet of coronoid
LUCL insertion
tends to avuse off of lateral epicondyle. It inserts on supinator crest
Monteggia classification
Bado:
1 anterior in kids commonly
2 posterior dislocato (subclassifications from proximal to far).
2 a is coronoid level. B is metaphysical junction. C is distal coronoid, D is distal half of ulna
3 is laterally
4 is both bone FF with radial head dislocation
Nerve with monteggia?
PIN
5 ligaments of IOM?
Central band is key. Accessory, distal oblique, proximal oblique, dorsal oblique accessory cord
When can you cast ulna?
Distal 2/3. 50% overlap and less than 10% displacement
DRUJ suspicion of
5 mm shortening, ulnar styloid avulsion, subluxation on XR or wide AP space on AP
