Upper limb trauma

Question 1

What is the mechanism of injury in fracture of the surgical neck of humerus?

Answer 1

FOOSH or fall directly onto shoulder in osteoporotic patient/post-menopausal women

Question 2

Management of undisplaced and displaced surgical neck of humerus fractures?

Answer 2

undisplaced = sling and gradual return to mobilisation
displaced = internal fixation

Question 3

What is a nightstick fracture and what is the mechanism of injury?

Answer 3

Fracture of ulnar shaft

Direct blow to the bone

Question 4

What is the management for fractures of both bones in the forearm?

Answer 4

Open reduction

Internal fixation

Question 5

Mechanism of injury in a scaphoid fracture?

Answer 5

FOOSH

Question 6

Typical presentation of a scaphoid fracture?

Answer 6

Tenderness in anatomical snuffbox

Pain on compression the thumb metacarpal

Question 7

How many X-Rays should be taken in a suspected scaphoid fracture and when will they be visible on X-Ray?

Answer 7

4 - AP, lateral & 2 oblique views

5% aren’t visible until 2 weeks after injury when fracture begins to heal

Question 8

Management of a scaphoid fracture?

Answer 8

Splint until fracture is confirmed with X-Ray

Plaster cast 6-12 weeks

Question 9

What are some complications of a scaphoid fracture?

Answer 9

Non-union (synovial fluid inhibiting fracture healing)

AVN (blood supply from branch of the radial artery)

Question 10

What is a typical punching injury in the hand?

Answer 10

Fracture of the 5th metacarpal