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Trauma > Upper Limb Injuries > Flashcards

Upper Limb Injuries Flashcards

1
Q

What causes a sternoclavicular dislocation?

A

Direct blow to the chest/shoulder.

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2
Q

What is the management for an anterior sternoclavicular dislocation?

A

Broad arm sling and fracture clinic.

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3
Q

What is the management for a posterior sternoclavicular dislocation?

A

Refer to orthopaedics. Complications - pneumothorax aspiration. CT mandatory.

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4
Q

What does the A-C joint stand for?

A

Acromioclavicular joint - provides horizontal stability to shoulder.

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5
Q

What does the Coraco-clavicular joint provide?

A

Vertical stability to the shoulder.

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6
Q

State a treatment for an A-C joint dislocation based on a type 2 Rockwood classification.

A

1) Type 1/2 - sling, ice.
2) Type 3 - immobilize in sling, prompt orthopaedic referral
3) Type 4-6 - sling, prom

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7
Q

State a cause of a clavicular fracture.

A

Blow to the shoulder.

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8
Q

State the most common site for a clavicular fracture.

A

80% middle of the shoulder (especially in children).

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9
Q

State a treatment for clavicular fracture.

A

Sling. Analgesia.

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10
Q

What is the most common large joint dislocation presented to ED?

A

Shoulder dislocation.

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11
Q

What are the majority of shoulder dislocations presented?

A

Anterior (95%). Posterior (2-3%).

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12
Q

State a clinical feature of a shoulder dislocation.

A

Painful shoulder. Arm abducted and externally rotated. Elbow flexed. Palpable head of humerus.

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13
Q

State a complication of a shoulder dislocation.

A

Axillary nerve injury. Axillary artery injury (bruising of lateral chest wall). Rotator cuff injury (damage to group of muscles/tendons that surround shoulder joint).

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14
Q

What is a Bony Bankart Lesion?

A

A lesion of the glenoid bone.

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15
Q

What is a Hill-Sachs Lesion?

A

A lesion of the humerus bone.

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16
Q

State 3 manipulation techniques for shoulder dislocation.

A

Hippocratic. Stinson’s/Hanging. Milch’s. Scapular manipulation method. Kocher’s.

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17
Q

Define the Hippocratic Method.

A

Surgeon grabs the affected side and forearm. Slow and gentle traction is applied and the arm is gently rotated internally/externally to disengage the head of the humerus.

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18
Q

Define the Stimson’s/Hanging.

A

Weights are taped to the wrist of the dislocated shoulder which hangs free over the edge of the table.

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19
Q

Define Milch’s manipulation technique.

A

With the patient lying supine (on the back), arm is raised by the side and externally rotated. Therapist uses their thumb to push the the head of the humerus back in the place.

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20
Q

Define the scapular manipulation method.

A

With the patient sitting, an assistant gradually lifts the arm to a horizontal position and applies gentle traction. With a thumb, push the tip of the scapula medially and upward (96% success rate).

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21
Q

What is the mneumonic for the Kocher’s method.

A

TEAM - Traction, External Rotation, Adduction, Medial Rotation.

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22
Q

Define the Kocher’s method.

A

Humeral head is levered on the anterior surface of the shoulder cavity and the long shaft of the humerus is levered against the chest wall until reduction is complete.

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23
Q

State a feature a fractured surgical neck of the humerus.

A

Elbow pain. Pain. Bruising on the shoulder. It’s common in the elderly.

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24
Q

State the different aspects of NEER Classification.

A

Part 1 - No displacement
Part 2 - Displacement of one fragment
Part 3 - Displacement of two individual fragments
Part 4 - Displacement of all four segments
5 - dislocation

25
Q

State the management of a fractured surgical neck of the humerus.

A

Broad arm sling. Analgesia.

26
Q

State a clinical feature of a mid shaft fracture of the humerus.

A

Pain and deformity over affected region. Tenderness and swelling.

27
Q

State a mechanism of injury for a fractured shaft of the humerus.

A

Direct blow. Fall on outstretched arm or elbow. Pathologic fracture e.g. breast cancer.

28
Q

State an associated injury to the fracture shaft of the humerus.

A

Radial nerve injury (wrist drop). Ulnar and medial nerve injury. Brachial artery injury.

29
Q

State a scan of the fractures shaft of the humerus.

A

X-ray scan of elbow and the shoulder.

30
Q

State the mneumonic for an elbow dislocation.

A

FOOSH - fallen onto an outstretched hand.

31
Q

State a feature of an elbow dislocation of an X-ray.

A

Olecranon pushed out.

32
Q

State a complication of an elbow dislocation.

A

Injury to the brachial artery, ulnar, median and radial nerves.

33
Q

State a cause of a fracture to the radial head.

A

FOOSH - fallen onto an outstretched hand.

34
Q

State a symptom of a fracture to the radial head.

A

Tender radial head. Tender on pronation & supination. Anterior and posterior fat pads raised off the bone.

35
Q

What are fat pads?

A

A mass of closely packed fat cells surrounded by fibrous tissue.

36
Q

State a cause of a supracondylar fracture.

A

Blow to the posterior aspect of the flexed elbow.

37
Q

State how a supracondylar fracture is appeared on a scan.

A

Distal humerus fracture displaced anteriorly.

38
Q

State a treatment for a supracondylar fracture.

A

Non-displaced fractures - splint immobilisation and early orthopaedic follow up. Displaced fracture - orthopaedic consultation.

39
Q

State a complication of a supracondylar fracture.

A

Neurologic - radial nerve, medial nerve and ulnar nerve damage.

40
Q

State a cause of a fracture to the olecranon.

A

FOOSH - fallen onto an outstretched hand/fall on the elbow.

41
Q

State a symptom of a fracture to the olecranon (elbow).

A

Tenderness and swelling.

42
Q

State what an olecranon fracture is associated with.

A

30% associated with other fractures. Ulnar nerve injury is common. Associated with a triceps rupture.

43
Q

State a cause of a fracture to forearm bones.

A

Great amount of force/direct blow. Falls. Rule out compartment syndrome.

44
Q

What is a Monteggia fracture?

A

Radial head pushed up. Proximal 1/3 ulnar fracture.

45
Q

State the mechanism of injury of a Monteggia fracture.

A

Direct blow to posterior aspect of the ulna. Fall on an outstretched hand.

46
Q

State which nerve is injured in a Monteggia fracture.

A

Radial nerve.

47
Q

State the management of a Monteggia fracture.

A

ORIF (plating of the fracture). Closed reduction/splinting.

48
Q

Define a Galeazzi fracture.

A

Fracture to distal 1/3 of radius (distal radio-ulnar dislocation).

49
Q

State the mechanism of a Galeazzi fracture.

A

Direct blow to the back of the wrist.

50
Q

State a complication of a Galeazzi fracture.

A

Ulnar nerve injury.

51
Q

State the management of a Galeazzi fracture.

A

ORIF (plating of the fracture).

52
Q

State the 4 types of a fracture to the distal radius.

A

1) Colles fracture - radial deviation and ulnar angulation. 2) Smith’s fracture - angulation of distal, radial articular surfaces.
3) Barton’s fracture - displacement of large fragment of radial articular surfaces
4) Hutchinson’s fracture - intra-articular fracture of the radial styloid process

53
Q

State the cause of a Colles fracture.

A

Falling on a wrist in extension (outstretched hand). Distal fracture is displaced dorsally (posteriorly).

54
Q

State the cause of a Smiths fracture.

A

Falling on a flexed wrist. Distal fracture is displaced ventrally (anteriorly).

55
Q

Define a Barton’s fracture.

A

Displacement of a large fragment of radial articular surfaces.

56
Q

Define a Hutchinson’s fracture.

A

Intra-articular fracture of the radial styloid process.

57
Q

Define a Barton’s fracture.

A

Fracture of the distal radius which extends through the dorsal aspect of the articular surface with associated dislocation of the radiocarpal joint.

58
Q

Define a Hutchinson’s fracture.

A

It’s a fracture of the radial styloid process.

59
Q

State a complication of the Hutchinson’s fracture.

A

Median nerve injury. Carpal tunnel syndrome - when nerves in hand (median nerve) is squeezed/compressed in wrist - pain and numbness. Sympathetic dystrophy (disorder that causes lasting pain usually in arm/leg). Haematoma block - analgesic technique used to allow painless manipulation of fractures.

Trauma (15 decks)

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