Upper limb fractures

Question 1

Colles fracture - MOI? management?

Answer 1

FOOSH outwards 
moulded short arm
closed reduction MUS
closed reduction MUA 
ORIF

Question 2

management of smith’s fracture ? is it stable ? MOI ?

Answer 2

fall onto back of hand carrying something
UNSTABLE injury
needs ORIF

Question 3

management of Bartons fracture?

Answer 3

unstable

ORIF

Question 4

Complications of wrist fractures

Answer 4

Pain, stiffness, arthritis
carpal tunnel syndrome
neurovascular damage
volkmann ischaemic syndrome

Question 5

name of fractures in kids

Answer 5

greenstick or buckle

Question 6

examination of wrist fractures?

Answer 6

NV - median, ulnar, radial
CRT, pulses
open / closed
other sites
DONT FORGET SCAPHOID

Question 7

imaging in wrist fracture

Answer 7

X ray - AP , lateral

+ SCAPHOID

Question 8

forearm fracture

what is fractured? management?

Answer 8

fracture of ulna and radial shaft

ORIF

Question 9

monteggia fracture

what is fractured? management?

Answer 9

ulnar shaft fracture with displacement of radial head at elbow
ORIF

Question 10

Galeazzi fracture

what is fractured? management?

Answer 10

radial shaft fracture with displacement of ulna at DRUJ

ORIF

Question 11

night stick fracture

what is it? MOI? management?

Answer 11

isolated ulnar fracture
self defence
ORIF

Question 12

significance of radial head fractures? what is there a risk of?

Answer 12

AVN

Question 13

management of type I, II, III radial head fractures

Answer 13

I = conservative
II = ORIF 
III = hemiarthroplasty

Question 14

management of olecranon fracture? what attaches to it?

Answer 14

triceps tendon

ORIF

Question 15

management of clavicle fractures

Answer 15

middle 1/3 sling

lateral 1/3 ORIF

Question 16

AC joint sprain management

Answer 16

only operate if overhead profession or >50% displaced

Question 17

commonest schouder dislocation? important examination? important x ray?

Answer 17

anterior dislocation
axillary nerve examination - regimental badge area
velpeau x ray

Question 18

3 risks with shoulder dislocation

Answer 18

rotator cuff injury - USS / MRI
axillary nerve damage - regimental badge sensation
glenoid labrum injury - MR arthrogram

Question 19

management of shoulder dislocation

Answer 19

sling or ORIF

Question 20

important examination in humeral head fracture

Answer 20

axillary nerve

Question 21

management of humeral head fracture

Answer 21

ORIF or hemiarthroplasty

Question 22

in what fracture is some angulation after reduction acceptable?

Answer 22

humeral shaft

Question 23

important risk with supracondylar fractures in children?

Answer 23

injury to anterior interosseous nerve and brachial plexus

Question 24

important nerve to examine in elbow dislocation

Answer 24

ant interosseous nerve

Question 25

treatment of 5th metacarpal neck fracture

Answer 25

splint 2-3w

Question 26

management of Bennetts fracture

Answer 26

1st MTP base fracture
intra articular!
so needs perfect reduction
3w moulded Bennetts cast

Question 27

presentation and management of scaphoid fracture

Answer 27

tenderness at anatomical snuffbox

6-12w in a moulded cast / ORIF

Question 28

complications of a missed scaphoid fracture

Answer 28

AVN, arthritis

Question 29

imaging of scaphoid fracture

Answer 29

XR - AP, lateral, scaphoid

+/- CT or MRI if any clinical suspicion

Question 30

what important ligaments in ankle?

Answer 30

lateral = ATFL, PTFL, CFL

syndesmosis

Question 31

what is syndesmosis? what does disruption indicate?

Answer 31

holds tibia and fibula together

disruption = instability

Question 32

imaging in ankle injuries?

Answer 32

x ray - AP, lateral + mortice view

Question 33

displaced ankle joint on x ray?

Answer 33

medial clearspace >4mm