Upper limb fractures Flashcards
Who are wrist fractures seen in?
2 groups
- young, active
- old, osteoporotic
What is the most common fracture?
Wrist
What are some types of wrist fractures?
Colles Smith's Barton Chauffeur's Greenstick
What is a colles fracture?
Distal radius fracture with dorsal displacement of fragents
Dinner fork deformity
What is a Smith’s fracture?
Distal radius fracture with volar displacement of fragments
What is a Barton fracture?
Fracture dislocation of radiocarpal joint
Caused by shearing force
What is a Chauffeur’s fracture?
Isolated fracture of radial styloid process
Who is a greenstick fracture seen in?
Children
What is the typical history in Colles fracture?
Fall onto outstretched hand
What is th typical history of a Smith’s fracture?
fall onto fully flexed hand
How are motor nerve examined in wrist fracture?
Median= squeeze finers
Ulnar= finger spread
radial= finger extension
Ant interosseus= thumb up and down
How are sensory nerves examined in wrist fracture?
Mediam= index Ulnar= pinkie Radial= dorsum
What is the management of wrist fracture?
Conservative- reduction and casting
Operative- percutaneous wires, ORIF
What are the indications for surgical management of wrist fracture?
Unstable
Extension into radoiocarpal joint
Loss of radial height or volar tilt
What is the most common fracture of carpus?
Scaphoid
Who typically gets scaphoid fractures?
20-30yo men
What is the common location of scaphoid fractures?
Waist of scaphoid
What is the classic presentation of scaphoid fracture?
Fall onto outstretched hand
Localised ain and tenderness in anatomical snuffbox
What is the investigation of suspected scaphoid fracture?
XR- ask specifically for scaphoid
What is the management of scaphoid fracture?
Cast immobilisation 6-8 weeks
What are some complications of scaphoid fracture?
Non union
Avascular necrosis - blood supply to distal associated w waist of scaphoid
What causes proximal humerus fractures?
Fall onto outstretch arm with osteoporosis
Trauma- sports, RTA
What causes distal humerus fractures?
Physical trauma to elbow
What is the management f humeral fracture?
Normally conservatice- cast/sling
What is a complication of humerus fracture?
Axillary nerve injury, esp humeral neck
Who are radial head fractures seen in?
Young adults
What normally causes radial head fractures?
Fall onto outstretch hand
What is the presentation of radial head fractures?
Marked local tenderness over head of radius
Impaired movement at elbow
Pain and impairment of pronation and supination
