upper limb fractures

Question 1

what is colles’ fracture?

Answer 1

fracture resulting after a fall onto extended outstretched hand

described as dinner fork type deformity

Question 2

what are the classical features of a colles’ fracture?

Answer 2

transverse fracture of radius
1 inch proximal to radio-carpal joint
dorsal displacement + angulation

Question 3

what are the symptoms of colles’ fracture?

Answer 3

pain in anatomical snuffbox region

can initially be missed on X ray

Question 4

what are the risks if a colles’ fracture is missed?

Answer 4

avascular necrosis
non-union

Question 5

what is a smith’s fracture?

Answer 5

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

Question 6

what is bennett’s fracture?

Answer 6

intra-articular fracture at base of thumb metacarpal
impact on flexed metacarpal, caused by fist fights

Question 7

what is the X ray finding of bennett’s fracture?

Answer 7

triangular fragment at base of metacarpal

Question 8

what is monteggia’s fracture?

Answer 8

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

Question 9

what is a galeazzi fracture?

Answer 9

radial shaft fracture with associated dislocation of the distal radioulnar joint

occur after a fall on hand with rotational force superimposed on it

Question 10

what are examination findings of a galeazzi fracture?

Answer 10

bruising, swelling + tenderness over lower end of forearm

Question 11

what are X ray findings of a galeazzi fracture?

Answer 11

displaced fracture of radius + prominent ulnar head due to dislocation of inferior radio-ulnar joint

Question 12

what is barton’s fracture?

Answer 12

distal radius fracture (colles/smiths) with associated radiocarpal dislocation

fall onto extended + pronated wrist

Question 13

what are scaphoid fractures?

Answer 13

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

Question 14

what are the physical signs of a scaphoid fracture?

Answer 14

swelling + tenderness in anatomical snuffbox

pain on wrist movements + on longitudinal compression of thumb

ulnar deviation AP needed for visualisation of scaphoid

Question 15

what are radial head fractures?

Answer 15

fracture of radial head- common in young adults
caused by fall on outstretched hand

Question 16

what are examination findings of radial head fractures?

Answer 16

marked local tenderness over head of radius
impaired movements at elbow
sharp pain at lateral side of elbow at extremes of rotation- pronation/supination