Upper limb disorders + bone stuff Flashcards
What is the most common malignant bone tumour in younger patients?
Osteosarcoma
<50 yrs
What is the most common malignant bone tumour in older patients?
Myeloma bone disease
>50yrs
How common is metastatic bone disease?
25x more common than primary bone tumours
what is a benign tumour of the skeleton?
Osteoid osteoma.
what is the malignant tumour of soft tissue?
Liposarcoma
What is the benign tumour of soft tissue?
Lipoma.
What happens when theres damage to the supraspinous muscle?
The humerus migrates superiorly - can’t abduct properly.
What is the diagnosis of a rotator cuff tear?
MRI
US
What is the treatment of a rotator cuff tear?
Ice
rest
NSAIDs
small exercise
surgery - open or closed.
Treatment of clavicular fracture?
Leave in most people - progressive mobilisation from 2 weeks onwards
adults with displaced bone - should have surgery.
Treatment of proximal humeral fracture?
younger - surgery
older - conservative
What is the most common fracture in older patients?
Distal radial fracture.
How is laceration of the flexor tendons treated?
Repair should be done in the position of injury
Which ligament is most commonly sprained in the shoulder?
acriomioclavicular,
coracoacromion
coracoclavicular
What is neuropraxia?
conduction loss of the nerve without structural changes.
What is a cause of Saturday night palsy?
Wrist drop - radial nerve
cause of compression under the arm.
What are causes of neuropraxia?
Saturday night compression
starvation of oxygen
compression
what is the prognosis for neuropraxia?
Should fully recover in weeks to months.
what is the Sunderland scale?
1 - neuropraxia - axon is intuit but theres an area not working
2- axonotmesis
what is neuropraxia, axonotmesis, neuronotmesis?
neuropraxia - conduction loss
axonotmesis - axon divided
neurotmesis - nerve divided
what is axonotmesis?
where the axons and their myelin sheath are injured
what is wallerian degeneration?
the nerve fibres distal to the injury disappear. the nerve fibres proximal shrink back to the last node of Ranvier. they still grow back.
what is the recovery for axonotmesis?
Sensory recovery is often better than motor recovery
what is neuronotmesis?
Complete division of the nerve - theres usually no recovery unless its repaired
what is a complication of neuronotmesis?
Neuroma
what is the rate of axonal growth?
1-3mm/day
what is trigger finger?
when swelling in the tendons catch on the pulleys, you can feel a lump in the palm.
what is treatment of trigger finger?
Steroids
splintage at night
surgery
What is duputrens disease?
it is an autosomal dominant disease - due to excessive production of collagen.
what is the treatment of duputrens disease?
splints don’t work
surgery
what is de quervains tenovaginitis?
pain in the tendons of the thumb side
where is the most common area of osteoarthritis?
Base of the thumb.
what is subacromial impingement?
pain when abducting the arm. caused when the acromioclavicular joint produces osteophytes
what are the signs of a posterior shoulder dislocation?
they can’t externally rotate their shoulder
what causes posterior shoulder dislocations?
Electric shock
epilepsy.
what nerve is commonly injured in shoulder dislocation?
Axillary nerve
