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CP3 Orthapedic # > Upper limb fractures > Flashcards

Upper limb fractures Flashcards

1
Q

Distal radius types

A

Most common orthopaedic injury
50% intraarticular

Colles-> dorsal displacement
Smiths-> volar displacement
Barron’s-> #dislocstion and infra articular

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2
Q

Distal radius clinical features

A 
Swelling 
Deformity -> dinner fork=colles
FOOSH
Pain
Decreased rom
Altered median sensation
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3
Q

Distal radius associated injuries

A

Joint dislocation

Radial styloid in high energy

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4
Q

Distal radius investigations

A

X Ray AP
-radial height >5mm shortening (top of ulnar to radial styloid)
-radial indination >5 degrees (line through both styloids)
-articular stop off >2mm (normally congruous)
Lateral
-volar tilt >5
CT -> evaluation inter articular damage

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5
Q

Distal radius management

A

Conservative

  • closed reduction and cast immobilisation
  • > extra articular
  • > <5mm radial shortening
  • > dorsal angulation <5

Surgery

  • fixation
  • > intraarticular
  • > unstable
  • > unsuitable angles/shortening

Physiotherapy

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6
Q

Distal radius complications

A 
Median neuropathy 30%
Ulnar neuropathy
EPL rupture
Arthrosis 2-30% 
Malunion
ECU/EPM entrapment 
Compartment
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7
Q

Scaphoid epidemiology

A

Most frequently # carpal bone
65% through waist
Blood supply enters dis tally

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8
Q

Scaphoid clinical features

A 
Axial load through hyperextended and radially deviated wrists 
Pain 
Swelling
Anatomical snuffbox tenderness
Scaphoid tubercle tenderness
 Pain on thumb compression 
Pain with resisted pronation
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9
Q

Scaphoid investigations

A

X Ray -> scaphoid views -> repeat 2 weeks later

MRI-> if suspicious after 2 weeks

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10
Q

Scaphoid management

A

Conservative

  • thumb spica cast immobilisation 3-4m
  • > stable and non displaced
  • > suspicion -> review in 2w

Surgery

  • > unstable
  • > proximal pole
  • > decreases time for Union
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11
Q

Scaphoid complications

A

Non Union
Scaphoid nonunion advanced collapse
Necrosis

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12
Q

Metacarpal epidemiology

A 
40% of all hand injuries 
Men 10-29y 
Neck most common
5th most common
Direct blow/rotational injury
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13
Q

Metacarpal clinical features

A 
?open
Deformity 
Malrotation
Pain and swelling
?neurovascular
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14
Q

Metacarpal investigations

A

X Ray

CT if complex

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15
Q

Metacarpal management

A

Conservative

  • immobilisation
  • > stable
  • > no rotational deformity

Surgery

  • > intracellular articular
  • > rotational maligment
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16
Q

Metacarpal complications

A

Tendon laceration
Neurovascular injury
Compartment syndrome
Stiffness

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17
Q

Phalanx epidemiology

A

Most common injury to the skeletal system
10% of all #
Most commonly distal phalanx

18
Q

Phalanx clinical features

A

Pain and swelling
Local tenderness
Deformity
?open

19
Q

Phalanx investigations

A

X Ray

20
Q

Phalanx management

A

Conservative

  • proximal and middle-> buddy tape
  • reduction and splint-> distal

Surgery
-ORIF-> unstable

21
Q

Phalanx complications

A

Decreased ROM
Malunion
Non Union
Nail bed injury

22
Q

Proximal numerous epidemiology

A

4-6% of all -#
Females
Elderly

23
Q

Proximal humerus clinical features

A

Pain and swelling
Decreased rom
Ecchymosis on chest, arm and forearm

24
Q

Proximal humerus investigations

A

X Ray

CT if intraarticular

25
Q

Proximal humerus management

A

Conservative

  • sling immobilisation, start rom in 2w
  • > non displaced 85%

Surgery

  • comminuted
  • unstable
  • anatomical neck
26
Q

Proximal humerus complications

A 
A vascular necrosis 
Axial nerve injury45% 
Mal Union
Non Union
Rotator cuff injury 
Adhesive capsulitis
Arthritis 
Infection
27
Q

Humeral shaft epidemiology

A

3-5%

Low energy in elderly

28
Q

Humeral shaft clinical features

A

Pain
Extremity weakness
Neurovascular

29
Q

Humeral shaft investigations

A

X Ray

30
Q

Humeral shaft management

A

Conservative

  • cooption splint followed by functional brace
  • > minimal displacement

Surgery

  • ORIF
  • > open
  • > neurovascular injury
31
Q

Humeral shaft management

A

Malunion
Non Union
Radial nerve palsy

32
Q

Radial head epidemiology

A

20% of all elbow injuries

33
Q

Radial head clinical features

A

FOOSH in pronation
Lateral pain and tenderness
Limited supination/pronation
Palpate wrist and inter osseos membrane

34
Q

Radial head investigations

A

X Ray
-fat pad signs ant and post humerus
CT if comminuted

35
Q

Radial head management

A

Conservative
-immobilisation

Surgery

  • displaced/angulation
  • comminuted
36
Q

Radial head complications

A 
DRUT injury 
Interosseous membrane disruption
Coronoid #
MCL/LCL injury 
Dislocation
Terrible triad-> dislocation and radial head and coranoid
Carpal #
Posterior interosseous nerve damage
Decreased forearm rotation
Stiffness
Arthritis 
Infection
37
Q

Clavicle epidemiology

A

4%
Young active pt
Direct blow to lateral shoulder

38
Q

Clavicle clinical features

A

Shoulder pain
Deformity
Tenting of the skin

39
Q

Radial head investigations

A

X Ray

40
Q

Clavicle management

A

Conservative

  • sling immobilisation with ROM 2-4w
  • > non displaced
  • > stable

Surgery

  • ORIF
  • > unstable
  • > open
  • > non Union
41
Q

Clavicle complications

A 
Ipsilateral shoulder # 
Scapulothoracic desociations 
Rib# 
Pneumothorax
Neurovascular injury 
Non Union

CP3 Orthapedic # (4 decks)

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