Upper limb injuries Flashcards
Clavivle fracture, where are the mrost common places?
Middle 1/3 (80%)
Lateral (12-15%), then Medial (5-6%)
hOW DO WE TREAT A BROKEN CLAVICLE? and when can we start mobilisation? In what circumstances would we do surgery?
You sling it (3-4 weeks)and strap it up. Most of the time you don’t need surgery.
Can start mobilisation after 2 weeks.
Surgery is only indicated when it is an open fracture, polytrauma, involving nerves, polytrauma, threatening the skin etc.
What do you see in acroio-clavicular injury?
Prominant clavicle bump
How do we treat acromioclavicular. injuries?
IId sprained, then sling, if dislocated then can do early fixation.
How do we trest the aillary nerve?
around the badge area, check sensation and ability to use the deltoid.
Why should we check the axillary nerve in acromioclavicular joint injuries?
Because if it is injured it wwill take longer to recover, as will need nerve to recover in order to use the deltoid muscle
What can’t you do with posterior dislocation? Would you have two?What is the most common fracture in an eldery patient?
externally rotate your arm (in comparrison to the other arm)
Dinner fork deformity=?
Colles fracture of the radius
Where does most scapoid fractures occur?
At the waist of the scaphoid bone and so can be hard to see, especially when the fracture is fresh
WHat do we need to see a scaphoid fracture?
If within 2 weeks then an MRI, otehrwise can cast it up and then check with an x ray after 2 weeks
Pain telescoping thumb and tenderness in hte anatomical snuff box =?
scaphoid fracture
Scaphoid strfracture treaatment?
cast (6 weeks). If displaced or there is non-union, then you may nede surgery.
What is Ulnar collateral ligament injury of the thumb? What do we see on examination of ulnar collateral ligament injury of the thumb?
“Skiers thumb”
The classic caught in drymatt and pulled back all the way, meaning that you can sprain or pull off a bit of the bone.
It will obviously be painful if you try to pull back the thumb. On radial stress the joint will open -> can pop it under pressure to open up the joint and then see it on xray.
WHAT IS A BENNETT’S FRACTURE\/?
Base of thumb fracture. Think Lee bennet got into a scrap and broke the bone at the base of his thumb (the ulnar (medial part) split off). Actually mainly caused by proximal pull from the abductor pollicis longus. (forced ABDUCTION causes it)
Treatment of ennetts fracture?
It is an unstable fracture and so it needsreduction and then maintanence reduction (plaster cast/wire/screw fixation)
What do we have to be concerned about win boxers/fighers?
A couple of things:
-Fight bites -> immuinocomprimised joint space and getting an infection -> needs looked at and any teeth scraped out and a good ol clean.
-boxers fracture (little/ring finger metacarpal neck) -> conservitive management ususally
What do we do in flexor tendon injuries ?
Need to save the tendons!! Wanting to get them back together asap. ALso careful of nerves.
Knife palm zones, hardest on and why?
1=intermediate phalynx
2= poximal phalynx
3= main plam, 4,5,6 = thumb and wrist
2 = danger zone as involves fds and fdp tendons (within flexor sheath,
What do we do with ligaments to help repair?
MOVE them!! Early movment reduces the risk of complete rupturing them!
Scaphoid injury, what do we ned to know and why do we need to act fast?
Becuas of the radial artery and so can lead to avascular necrosis.
In what position is the hip most stable (flexeed or extended)
Extended, why car crashes can lead to much worse outcomes!
What is the mom=vemetn availabel at the anc==kle joinT/
Flexion and extension only
What movement is the wrist able to do?
Circles! (VCircumflexion)
