upper limb fractures Flashcards
what is colles’ fracture?
fracture resulting after a fall onto extended outstretched hand
described as dinner fork type deformity
what are the classical features of a colles’ fracture?
transverse fracture of radius
1 inch proximal to radio-carpal joint
dorsal displacement + angulation
what are the symptoms of colles’ fracture?
pain in anatomical snuffbox region
can initially be missed on X ray
what are the risks if a colles’ fracture is missed?
avascular necrosis
non-union
what is a smith’s fracture?
reverse colles’ fracture
volar angulation of distal radius fragment- garden spade deformity
caused by falling backwards onto palm of outstretched hand or falling w flexed wrists
what is bennett’s fracture?
intra-articular fracture at base of thumb metacarpal
impact on flexed metacarpal, caused by fist fights
what is the X ray finding of bennett’s fracture?
triangular fragment at base of metacarpal
what is monteggia’s fracture?
dislocation of proximal radio-ulnar joint in association with an ulna fracture
fall on outstretched hand with forced pronation
needs prompt diagnosis to avoid disability
what is a galeazzi fracture?
radial shaft fracture with associated dislocation of the distal radioulnar joint
occur after a fall on hand with rotational force superimposed on it
what are examination findings of a galeazzi fracture?
bruising, swelling + tenderness over lower end of forearm
what are X ray findings of a galeazzi fracture?
displaced fracture of radius + prominent ulnar head due to dislocation of inferior radio-ulnar joint
what is barton’s fracture?
distal radius fracture (colles/smiths) with associated radiocarpal dislocation
fall onto extended + pronated wrist
what are scaphoid fractures?
commonest carpal fracture
surface of scaphoid is covered by articular cartilage w 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
what are the physical signs of a scaphoid fracture?
swelling + tenderness in anatomical snuffbox
pain on wrist movements + on longitudinal compression of thumb
ulnar deviation AP needed for visualisation of scaphoid
what are radial head fractures?
fracture of radial head- common in young adults
caused by fall on outstretched hand
what are examination findings of radial head fractures?
marked local tenderness over head of radius
impaired movements at elbow
sharp pain at lateral side of elbow at extremes of rotation- pronation/supination
