upper limb fractures Flashcards
which pole is at risk in a scaphoid fracture
proximal
cause of scaphoid fracture
FOOSH
on Ex of scaphoid fracture
tender over anatomical snuffbox
Ix for scaphoid fracture
AP, lateral and scaphoid view
-MRI IS THE DEFINITIVE
what do you do if no xray evidence of fracture but high index of suspicion
cast and re image in 10 days
MX of scaphoid fracture
non displaced –> strict immobilisation in cast / splint
displaced –> ORIF and screw
contents of anatomical snuffbox
radial artery, radio nerve and cephalic vein
complications of scaphoid fracture
avascular necrosis and non union
what is a colles fracture
extraarticular fracture of the distal radius with dorsal angulation of the distal segment
deformity in a colles fracture
dinner fork deformity
mechanism of colles
FOOSH
what is a bartons fracture
distal radial fracture with associated dislocation of the radio-carpal joint
3 features looked for on Xray of distal radius
radial height, volar tilt and radial inclinicaton
what should radial height be
11mm (radius should always be longer than ulnar otherwise get radial deviation and prominence of the ulnar head)
what should the volar tilt be
11 degrees when looking on from a lateral view
what should the radial inclination be
22 degrees (line perpendicular to long axis of radius to styloid
complications of a distal radial fracture
malunion or median nerve palsy
Mx of distal radial fracture
closed reduction and immobilisation in a below elbow backstab cast and then repeat xray at 1 week
what deformity do you get in a smiths fracture (volar angulation of the distal segment)
garden spade
sensation supply of the musculocutaenous nerve
the lateral forearm
musculocutaenous nerve injuries are rare as the nerve is protected by the biceps, but how can it be injured
in stab wounds
what does the axillary nerve supply
deltoid (abduction) and teres minor (external rotation)
what muscles does the radial nerve supply
triceps and the posterior compartment of the forearm
deformity in a radial nerve palsy
wrist drop
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
what is a galeazzi fracture
fracture of radial SHAFT with dislocation of radioulnar joint
what is a monteggia fracture
fracture of ulnar shat with dislocation of the PROXIMAL radioulnar joint
what is a Bennett fracture
intraarticular fracture at the base of the thumb (from a fist fight)
Mx of choice for a radial head subluxation
passive supination with arm held at 90 degrees
