Upper limb fractures

Question 1

What is a colles fracture?

Answer 1

FOOSH

Dinner fork

Question 2

3 features of colles

Answer 2

1. Transverse fracture of the radius
2. 1 inch proximal to the radio-carpal joint
3. Dorsal displacement and angulation

Question 3

What is a smiths fracture

Answer 3

reverse colles fracture

volar angulation of distal radius fracture - garden spade deformity

Question 4

causes of smiths fracture

Answer 4

falling backwards on outstretched hand

falling with wrists flexed

Question 5

what is Bennett fracture

Answer 5

Intra-articular fracture at the base of the thumb metacarpal
Impact on flexed metacarpal, caused by fist fights
X-ray: triangular fragment at the base of metacarpal

Question 6

what is monteggias fracture

Answer 6

Dislocation of the proximal radioulnar joint in association with an ulna fracture

Fall on outstretched hand with forced pronation

Needs prompt diagnosis to avoid disability

Question 7

galeazzi fracture

Answer 7

Radial shaft fracture with associated dislocation of the distal radioulnar joint

Occur after a fall on the hand with a rotational force superimposed on it.

On examination, there is bruising, swelling and tenderness over the lower end of the forearm.

X Rays reveal the displaced fracture of the radius and a prominent ulnar head due to dislocation of the inferior radio-ulnar joint.

Question 8

bartons fracture

Answer 8

Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation

Fall onto extended and pronated wrist

Question 9

scaphoid fracture

Answer 9

Scaphoid fractures are the commonest carpal fractures.

Surface of scaphoid is covered by articular cartilage with small area available for blood vessels (fracture risks blood supply)

Forms floor of anatomical snuffbox

Risk of fracture associated with fall onto outstretched hand (tubercle, waist, or proximal 1/3)

The main physical signs are swelling and tenderness in the anatomical snuff box, and pain on wrist movements and on longitudinal compression of the thumb.

Ulnar deviation AP needed for visualization of scaphoid

Immobilization of scaphoid fractures difficult

Question 10

radial head fracture

Answer 10

Fracture of the radial head is common in young adults.

It is usually caused by a fall on the outstretched hand.

On examination, there is marked local tenderness over the head of the radius, impaired movements at the elbow, and a sharp pain at the lateral side of the elbow at the extremes of rotation (pronation and supination).