Upper limb fractures Flashcards
Which fractures heal better: Upper limb or lower limb?
Upper limb
What is the healing time for upper limb fractures in mature skeletons?
6 weeks
What is the healing time for upper limb fractures in immature skeletons?
3 weeks
How do most upper limb fractures happen?
From falling down on an outstretched hand (FOOSH)
What causes transverse fractures?
High energy injuries causing more soft tissue damage
Which types of fractures require the longest time to heal?
Transverse fractires
What do you need to consider when interpreting the displacement pattern of a fracture?
1) Muscle pull
2) Direction of the causative injury
3) Gravity
Where do most clavicle fractures occur?
In the middle third:
Proximal piece = pointed cranially (due to pull of SCM muscle)
Distal piece = pointed caudally (due to pull of arm)
Which clavicle fractures are usually unstable and why?
Lateral third; because they involve ligamentous injuries
Management for middle third clavicle fractures?
Conservative (sling or figure of 8 brace)
Management for lateral third clavicle fractures?
Surgical fixation
___(Surgical/Anatomical) neck fractures have a high risk of AVN of the head of humerus.
Anatomical
What kind of fractures are greater tuberosity fractures?
Avulsion fractures (by the pull of the supra and infraspinatus muscles)
Greater tuberosity fractures can be associated with:
Shoulder dislocations
___(Surgical/Anatomical) neck fractures are the most frequent and are considered ___ fractures.
Surgical; Fragility
Which nerve is in close proximity to the proximal humerus fractures?
Axillary nerve
Which nerve would be injured in distal humerus fractures?
Radial nerve
What would happen if the radial nerve is injured?
1) Wrist drop
2) Decreased sensation in the dorsal aspect of the first web space
Are olecranon fractures intra or extraarticular?
Intraarticular
Why is a fracture gap usually seen in olecranon fractures?
Because it is usually an avulsion injury due to forceful pull of the triceps
Why don’t children need anatomical reduction and absolute fixation in forearm fractures?
Because they have a high remodeling capacity
What are Monteggia fracture dislocations?
1) Fracture of the proximal half of the ulna
2) Dislocation of the proximal radius
3) Possible injury to radial nerve
What would happen if the radial nerve was injured in a Monteggia fracture dislocation?
Finger drop
What are Galeazzi fracture dislocations?
1) Fracture of the distal half of the radius
2) Dislocation of the distal ulna
3) Possible injury to ulnar nerve
What would happen if the ulnar nerve was injured in a Galeazzi fracture dislocation?
1) Weakness of finger abduction/adduction
2) Positive Froment’s sign
Isolated ulna fracture is also called:
Nightstick injury
What causes an isolated ulnar fracture?
Direct trauma to the ulna
An isolated ulnar fracture has a risk of:
Non-union (metaphysis)
Is Colle’s fracture intra or extra articular?
Extra-articular
What is Colle’s fracture?
Extra-articular fracture of the distal radius
What causes Colle’s fracture?
Simple trauma in the elderly (Fragility fracture)
In Colle’s fracture, the distal radius is ___(dorsally/ventrally) displaced.
Dorsally
Patients presenting with Colle’s fracture have what deformity?
Dinner fork deformity
What is the treatment for Colle’s fracture?
Closed reduction and casting for 6 weeks
Smith’s fracture is also called:
Reverse Colle’s
In Smith’s fracture, the distal radius is ___(dorsally/ventrally) displaced.
Ventrally
What causes Smith’s fracture?
By falling down with the wrist in flexion
What causes Colle’s fracture?
By falling down with the wrist in extension
What is the treatment for Smith’s fracture?
Closed reduction and casting for 6 weeks
Is Barton’s fracture an intra or extra articular fracture?
Intra-articular
Which fracture resembles a triangle?
Barton’s fracture
What is the treatment for Barton’s fracture?
Anatomical reduction and fixation
Radial styloid fracture is also called:
Chauffeur fracture
What causes radial styloid fractures?
Sudden forceful radial deviation of the wrist
Are radial styloid fractures intra or extra articular?
Intra-articular
What is the treatment for radial styloid fractures?
Anatomical reduction and fixation