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MSK > Upper Limb Trauma > Flashcards

Upper Limb Trauma Flashcards

1
Q

Who usually presents with humeral neck fractures?

A

Low energy injury in osteoporotic bone due to FOOSH in elderly people

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2
Q

Describe the common pattern of humeral neck fracture

A

Fracture of surgical neck and medial displacement of humeral shaft due to pull of pectorals major

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3
Q

How is a humeral neck fracture treated?

A

Sling
Gradual return to mobilisation
Internal fixation if persistently displaced

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4
Q

What type of humeral neck fractures are hard to treat and usually require replacement?

A

Comminuted

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5
Q

When do acromioclavicular joint injuries commonly occur?

A

Fall onto the point of the shoulder during sports

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6
Q

If acromioclavicular joint is subluxed what will happen?

A

AC ligament rupture

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7
Q

If acromioclavicular joint is dislocated what will happen?

A

Coracoclavicular ligaments and AC ligament disruption

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8
Q

How are acromioclavicular joint injuries treated?

A

Sling and physio

Reconstruction of coracoclavicular ligament if chronic pain or an athlete

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9
Q

What causes a humeral shaft fracture?

A

Direct trauma - RTA resulting in transverse or comminute fractures
Fall - oblique/spiral

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10
Q

What nerve is at risk in a humeral shaft fracture?

A

Radial nerve

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11
Q

How are humeral shaft fractures treated?

A

Non-operatively with a brace
Internal fixation in poly-trauma
Non-union - plating/grafting

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12
Q

Name four elbow injuries

A
  • supracondylar fracture
  • intra-articular distal humerus fracture
  • olecranon fractures
  • dislocation and fracture dislocation
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13
Q

What treatment does an intra-articular distal humerus fracture require?

A

Open reduction, internal fixation with reduction to minimise loss of function

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14
Q

How does an olecranon fracture occur?

A

Fall to the elbow with contraction of triceps

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15
Q

How is an olecranon fracture managed?

A

Open reduction, internal fixation used to restore triceps and articular surface

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16
Q

What type of elbow dislocation usually occurs?

A

Posterior - after fall onto an outstretched hand

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17
Q

How is elbow dislocation managed?

A

Reduction and sling unless associated fractures

18
Q

What is the name given to an ulnar shaft fracture?

A

Nightstick fracture

19
Q

When do nightstick fractures occur?

A

After direct blow

20
Q

Describe the management for a nightstick fracture

A

Conservative but ORIF may mean an earlier return to function

21
Q

What is a monteggia fracture?

A

Ulna fracture with dislocation of radial head at the elbow

22
Q

How is a moteggia fracture managed?

A

X-ray

ORIF

23
Q

What is a galeazzi fracture?

A

Fracture of the radius with dislocation of the ulna at the radioulnar joint

24
Q

How is a galeazzi fracture managed?

25
Q

What is a colles fracture?

A

FOOSH

Extra-articular fracture of the distal radius with dorsal displacement

26
Q

How is a colles fracture treated?

A

Displaced - splintage

Comminution/unstable - K wires or ORIF with plate/screws

27
Q

What are the complications of a colles fracture?

A

Carpal tunnel

Extensor pollicis longus rupture

28
Q

Describe the radiology of a colles fracture

A

PA and lateral wrist xray

Fork deformity

29
Q

What is a Smith’s fracture?

A

Fracture of the distal radius after falling onto the back of a flexed wrist with volar displacement

30
Q

How is a smith’s fracture treated?

A

ORIF with plate and screws - unstable

31
Q

What is a bartons fracture?

A

Intra-articular fracture of distal radius involving dorsal/volar rim

32
Q

What are the volar bartons and dorsal bartons the same as?

A

Smiths intra-articular

Colles intra-articular

33
Q

How are Barton’s fractures managed?

34
Q

How will a scaphoid fracture present?

A

FOOSH, swollen hand with tender anatomical snuff box

Pain on compressing the thumb

35
Q

Describe the management for a scaphoid fracture

A

4 Xray views

Undisplaced - cast 6-12 weeks

36
Q

State the complications of a scaphoid fracture

A

Non-union, avascular necrosis due to distal blood supply

Displaced - compression screw sunk into bone to avoid non-union

37
Q

What is the name for dislocation of the carpal bone around the lunate?

A

Per-lunate dislocation - hyperdorsiflexion

38
Q

Which direction will the lunate dislocate?

A

Volarly whilst carpal bones remain enlocated

‘split cup’ lunate tilted and empty

39
Q

What type of dislocation has a high risk of osteoarthritis?

A

Scapho-lunate dislocation

40
Q

Name four hand injuries

A
  • penetrating hand injuries
  • mallet finger
  • metacarpal fracture
  • phalangeal fracture
41
Q

What is Mallet finger?

A

Avulsion of the extensor tendon from its insertion into the terminal phalanx caused by forced flexion of an extended DIP often from a ball

42
Q

How will mallet finger present?

A

Pain and inability to extend DIP splint required 24/7 for at least 4 weeks

MSK (22 decks)

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