Upper Limb Trauma Flashcards
Who usually presents with humeral neck fractures?
Low energy injury in osteoporotic bone due to FOOSH in elderly people
Describe the common pattern of humeral neck fracture
Fracture of surgical neck and medial displacement of humeral shaft due to pull of pectorals major
How is a humeral neck fracture treated?
Sling
Gradual return to mobilisation
Internal fixation if persistently displaced
What type of humeral neck fractures are hard to treat and usually require replacement?
Comminuted
When do acromioclavicular joint injuries commonly occur?
Fall onto the point of the shoulder during sports
If acromioclavicular joint is subluxed what will happen?
AC ligament rupture
If acromioclavicular joint is dislocated what will happen?
Coracoclavicular ligaments and AC ligament disruption
How are acromioclavicular joint injuries treated?
Sling and physio
Reconstruction of coracoclavicular ligament if chronic pain or an athlete
What causes a humeral shaft fracture?
Direct trauma - RTA resulting in transverse or comminute fractures
Fall - oblique/spiral
What nerve is at risk in a humeral shaft fracture?
Radial nerve
How are humeral shaft fractures treated?
Non-operatively with a brace
Internal fixation in poly-trauma
Non-union - plating/grafting
Name four elbow injuries
- supracondylar fracture
- intra-articular distal humerus fracture
- olecranon fractures
- dislocation and fracture dislocation
What treatment does an intra-articular distal humerus fracture require?
Open reduction, internal fixation with reduction to minimise loss of function
How does an olecranon fracture occur?
Fall to the elbow with contraction of triceps
How is an olecranon fracture managed?
Open reduction, internal fixation used to restore triceps and articular surface
What type of elbow dislocation usually occurs?
Posterior - after fall onto an outstretched hand
How is elbow dislocation managed?
Reduction and sling unless associated fractures
What is the name given to an ulnar shaft fracture?
Nightstick fracture
When do nightstick fractures occur?
After direct blow
Describe the management for a nightstick fracture
Conservative but ORIF may mean an earlier return to function
What is a monteggia fracture?
Ulna fracture with dislocation of radial head at the elbow
How is a moteggia fracture managed?
X-ray
ORIF
What is a galeazzi fracture?
Fracture of the radius with dislocation of the ulna at the radioulnar joint
How is a galeazzi fracture managed?
Xray
ORIF
