upper limb injuries Flashcards
where is most common place to fracture clavicle
middle 1/3
then lateral
management of clavicular fracture
majority heal
analgesia
sling 3-4 weeks
progressive mobilisation from 2 weeks
surgery needed if displaced or open fracture or threatening neurovasculature- uncommon
acromioclavicular joint is injured by
falling on to point of shoulder, common in sporting accidents. can be sprain or dislocation
treatment of AC joint injury
sprains- sling for 3-4 weeks
displaced- may benefit from early fixation surgery
proximal humerus fractures epidemiology
similar to hip fractures
young high energy
elderly osteoporotic
management of proximal humeral fracture
sling mobilise for 6 weeks
fixation with plate or joint replacement - usually elderly
recurrence increases with younger age, male sex and participation in contact sports
investigation for shoulder dislocation
two views on xray MANDATORY as many are missed esp posterior
test axillary nerve- regimental badge. if damaged then long rehab
check passive external rotation (unilateral loss) in posterior dislocation
most common shoulder dislocation
anterior (80-85%)
then posterior
then inferior (<5%)
treatment of shoulder dislocation
acute- reduction under sedation/anaesthetic
distal radial fracture
commonest fracture in elderly. fall on outstretched hand (FOOSH)
high velocity injury in young
dinner fork deformity
distal radial fracture treatment
undisplaced - splint/cast
minimally displaced- reduce, cast with or without wires
significantly displaced- surgical plate or external fixator
colles fracture
involves a break in the radius bone of the forearm near the wrist. most common type of wrist fracture
scaphoid fracture diagnosis, investigations
most common fractured bone in carpus
often difficult to see on xray
repeat x ray at 2 weeks or MRI
fall onto outstretched hand (FOOSH)
pain base of thumb
tenderness anatomical snuff box
pain telescoping thumb
scaphoid fracture treatment
cast 6 weeks
surgery if displaced with screw or non union with screw or bone graft
how does ulnar collateral ligament injury of thumb happen
radial force
“skiers thumb”
“gamekeepers thumb”
