upper limb fractures Flashcards

1
Q

which pole is at risk in a scaphoid fracture

A

proximal

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1
Q

cause of scaphoid fracture

A

FOOSH

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2
Q

on Ex of scaphoid fracture

A

tender over anatomical snuffbox

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3
Q

Ix for scaphoid fracture

A

AP, lateral and scaphoid view

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4
Q

what do you do if no xray evidence of fracture but high index of suspicion

A

cast and re image in 10 days

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5
Q

MX of scaphoid fracture

A

non displaced –> strict immobilisation in cast / splint
displaced –> ORIF and screw

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6
Q

contents of anatomical snuffbox

A

radial artery, radio nerve and cephalic vein

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7
Q

complications of scaphoid fracture

A

avascular necrosis and non union

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8
Q

what is a colles fracture

A

extraarticular fracture of the distal radius with dorsal angulation of the distal segment

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9
Q

deformity in a colles fracture

A

dinner fork deformity

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10
Q

mechanism of colles

A

FOOSH

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11
Q

what is a bartons fracture

A

distal radial fracture with associated dislocation of the radio-carpal joint

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12
Q

3 features looked for on Xray of distal radius

A

radial height, volar tilt and radial inclinicaton

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13
Q

what should radial height be

A

11mm (radius should always be longer than ulnar otherwise get radial deviation and prominence of the ulnar head)

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14
Q

what should the volar tilt be

A

11 degrees when looking on from a lateral view

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15
Q

what should the radial inclination be

A

22 degrees (line perpendicular to long axis of radius to styloid

16
Q

complications of a distal radial fracture

A

malunion or median nerve palsy

17
Q

Mx of distal radial fracture

A

closed reduction and immobilisation in a below elbow backstab cast and then repeat xray at 1 week

18
Q

what deformity do you get in a smiths fracture (volar angulation of the distal segment)

A

garden spade

19
Q

sensation supply of the musculocutaenous nerve

A

the lateral forearm

20
Q

musculocutaenous nerve injuries are rare as the nerve is protected by the biceps, but how can it be injured

A

in stab wounds

21
Q

what does the axillary nerve supply

A

deltoid (abduction) and teres minor (external rotation)

22
Q

what muscles does the radial nerve supply

A

triceps and the posterior compartment of the forearm

23
Q

deformity in a radial nerve palsy

A

wrist drop

24
what is thoracic outlet syndrome
compression of brachial plexus + subclavian artery / vein at the thoracic outlet get wastage of the muscles of the hand +/- weakness +/- vascular signs (less common) Need to do Xray of chest and cervical spine first for any bony abnormalities, then do MRI to look at the nerve routes
25
what is a galeazzi fracture
fracture of radial SHAFT with dislocation of radioulnar joint
26
what is a monteggia fracture
fracture of ulnar shat with dislocation of the PROXIMAL radioulnar joint
27
what is a Bennett fracture
intraarticular fracture at the base of the thumb (from a fist fight)
28
Mx of choice for a radial head subluxation
passive supination with arm held at 90 degrees