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Year 2- MSK > Upper Limb Injuries > Flashcards

Upper Limb Injuries Flashcards

1
Q

Which part of the clavicle is most commonly fractured?

A

Middle 1/3- 80%

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2
Q

What commonly causes clavicular fracture?

A

Fall onto shoulder outstretched hand

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3
Q

How are clavicular fractures treated?

A

Vast majority unite themselves
Analgesia
Sling for 3-4 weeks for progressive mobilization

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4
Q

When are clavicular fractures operated on?

A

Rarely
Very displaced fractures
Open fractures when bone is piercing through skin
Polytrauma
Neurovascular complication

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5
Q

When in the acromioclavicular joint commonly injured?

A

In sports injuries, commonly rugby

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6
Q

What is the treatment for acromioclavicular injuries?

A

Sprains treated using a sling for 3-4 weeks
Displaced AC dislocations may benefit from early fixation

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7
Q

Define dislocation.

A

Complete loss of contact between two ends of a joint

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8
Q

What is the common cause of proximal humerus fractures in younger patients?

A

High energy injuries e.g. fall from height or motor vehicle accidents

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9
Q

What is the common cause of proximal humerus fractures in older patients?

A

Osteoporotic injuries

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10
Q

What is conservative management of proximal humerus fractures?

A

Sling- mobilising for 6 weeks

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11
Q

What is surgical management of proximal humerus fractures?

A

Fixation with plate
Joint replacement

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12
Q

RECAP- most mobile joint in the body?

A

Shoulder joint

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13
Q

Three types of shoulder dislocation?

A

Anterior
Posterior
Inferior

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14
Q

What nerve may be damaged in shoulder dislocation?

A

Axillary nerve

->test regimental badge area

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15
Q

If axillary nerve is damaged, rehabilitation will take a while. Which muscle in particular won’t work?

A

Deltoid muscle

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16
Q

How many x-ray views are required for shoulder dislocations?

A

Two because high proportion of posterior dislocations are missed

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17
Q

Treatment for shoulder dislocation?

A

Acute-reduction of dislocation under sedation or anaesthetic

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18
Q

Who is at a higher risk of shoulder dislocation reoccurrence?

A

Younger age, male sex, participation in contact sports

->these patients get treated more aggressively and often undergo surgical stabilisation to reduce risks of reoccurrence

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19
Q

What are the common causes of posterior shoulder dislocation?

A

Seizures
Electrocution
Direct blow to shoulder e.g. boxing

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20
Q

How is a diagnosis of a posterior shoulder dislocation made?

A

Checking passive external rotation- there will be unilateral loss
X-ray

->beware of bilateral posterior dislocation in seizures and electrocution

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21
Q

What is the classic appearance of the humerus in a posterior dislocation on x-ray?

A

Light bulb

22
Q

Distal radial fractures in younger patients are usually because of high velocity injuries e.g. falling from height or vehicle injuries.
Older patients can get these # because of lower velocity injuries like what?

A

Falls, classically onto an outstretched hand

->other causes = osteoporotic

23
Q

What is the most common fracture in older patients?

A

Distal radial fracture

->think of Granny

24
Q

How are undisplaced distal radial fractures treated conservatively?

A

Splints/casts

25
Q

How are displaced distal radial fractures treated conservatively?

A

Reduce fracture first by pulling bone back into position
Then cast with wiring

26
Q

How may a distal radial fracture be treated surgically?

A

Plates
External fixation

->most are treated conservatively though

27
Q

Complications of distal radial fractures?

A

Malunion
DRUJ pain (distal radioulnar joint)
EPL rupture (extensor pollicus longus, runs along back of fracture)
Carpal Tunnel syndrome
CRPS- chronic regional pain syndrome

28
Q

Which bone is the most commonly fractured bone in the carpus?

A

Scaphoid bone

29
Q

Are scaphoid fractures easy to see on x-ray?

A

No, difficult to see on initial x-ray so repeat x-rays are taken 2 weeks after leaving the patient in a cast

->early MRI’s more common now as can identify a fracture immediately after it has happened

30
Q

How does scaphoid fracture occur?

A

Falling onto outstretched hand commonly

31
Q

Where will pain be felt in a scaphoid fracture?

A

Pain at the base of thumb, pain telescoping thumb (pushing thumb up and down mainly)
Tenderness of the anatomical snuff box

32
Q

Which area of the scaphoid bone can damage the blood supply if fractured?

A

Fracture in the middle third of scaphoid

33
Q

How are scaphoid fractures treated?

A

6 weeks in a cast or splint

If displaced, or there in non-union, can be treated surgically

34
Q

What causes ulnar collateral ligament injury of thumb?

A

Radial force

-> known as gamekeepers thumb as ruptured when using a shotgun or skiers thumb

35
Q

Ulnar collateral ligament injuries of thumb can injure the ligament only but may also pull off some bone (avulsion fracture).
What is usually the presenting complaint?

A

Pain over radial border with history of injury
Weak pinch grip

36
Q

What would be seen upon examination of a ulnar collateral ligament injury of the thumb?

A

Tender ulnar side joint (called ulnar side of finger so side of thumb closest to ulna, use this as won’t change with pronation and supination

37
Q

How is a UCL injury of thumb treated conservatively?

A

Splint or cast

38
Q

How is a UCL injury of thumb treated operatively?

A

Repair ligament
Fixing any avulsion fracture

39
Q

Where does Bennett’s fracture occur?

A

Thumb (intra-articular fracture at the base of the 1st metacarpal)

->idk maybe think of Amy B being a teacher, doing heads down thumbs up??

40
Q

What are some of the common causes of Bennett’s fracture?

A

Boxing
Falling on outstretched hand

41
Q

There is often displacement in Bennett’s fracture, why is this?

A

Proximal pull from abductor pollicus longus

42
Q

What is the treatment of Bennett’s fracture?

A

Reduction of fracture
Maintenance of this reduction using plaster cast and wiring and screw fixation

43
Q

What is something to be aware of in fighting injuries?

A

There may be pieces of teeth in the laceration in MCP joint- cause for infection which can lead to septic arthritis of this joint

->known as fight bites

44
Q

Boxer’s fracture?

A

Fracture of little finger metacarpal neck

(may also be ring finger)

45
Q

How is boxer’s fracture usually treated?

A

Conservatively, reducing if significant angulation

->note that reducing means reducing space between bone(s) involved in a fracture

46
Q

What is the usual cause of flexor tendon injuries of the fingers?

A

Knife laceration e.g. fish gutting or cutting food in kitchen

->tends to be young adults, male>female

47
Q

How are flexor tendon injuries of the fingers treated?

A

Early surgical repair

48
Q

Which flexor tendons of the fingers have the worst prognosis if injured?

A

FDS and FDP

49
Q

How are flexor tendon finger injuries repaired?

A

Secure low profile sutures

->partial tears (<60%) do not need repair

50
Q

What is involved in rehabilitation of flexor tendon finger injuries?

A

Early movement increases healing and strength

51
Q
A

Year 2- MSK (36 decks)

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