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NMSK 2 - upper limb > forearm, wrist and hand fractures > Flashcards

forearm, wrist and hand fractures Flashcards

(49 cards)

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1
Q

what is a monteggia fracture?

A

-fracture on the proximal ulna in association with a radial head dislocation

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2
Q

what is the MOI of a monteggia fracture?

A

fal on outstretched fully pronated arm

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3
Q

how is a monteggia fracture managed?

A

-ORIF
-cast above elbow in 90 degrees flexion to below wrist and in supination x4-6 weeks
-physio post cast

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4
Q

what is a galeazzi fracture?

A

-fracture of distal 1/3 of radius

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5
Q

what is a galeazzi fracture associated with?

A

a distal radioulnar joint injury

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6
Q

what complications are associated with a galeazzi fracture?

A

-malunion
-unstable distal fragment

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7
Q

how is a galeazzi fracture managed?

A

-ORIF - plate and screws
-cast as for monteggia

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8
Q

what is the MOI for a radial and ulna fracture?

A

-twisting injury / rotational deformity

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9
Q

what are the complications for a radius and ulna fracture?

A

-mal union
-non union
-compartment syndrome

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10
Q

what is the conservative management of a radius and ulna?

A

-not usually successful due to unopposed supination due to rotational deformity and slippage

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11
Q

how is a radial and ulna fracture treated surgically?

A

-ORIF - treatment of choice for this fracture
-cast above elbow

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12
Q

what is acute compartment syndrome?

A

-can happen after fracture - due to pressure increase - leading to ischaemia
-affects flexor muscles in forearm
can also affect median nerve, brachial artery etc

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13
Q

what condition can a patient have if their acute compartment syndrome is not treated?

A

-volkmann’s ischaemic contracture

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14
Q

what pressure in compartment syndrome requires fasciotomy?

A

30mmhg

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15
Q

list symptoms of compartment syndrome

A

-pain
-swelling
-numbness
-pins and needles
-painful ROM

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16
Q

what is a colles fracture?

A

fracture of distal radius but the broken end of radius is bent backwards (dorsally displaced)

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17
Q

what age pop is coleus fracture common in?

A

-common in middle aged and elderly women
-NB osteoporosis

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18
Q

what is the MOI for a colles fracture?

A

fall on outstretched hand

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19
Q

what is a smiths fracture?

A

fracture of distal radius w/ volar displacement

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20
Q

what is Bartons fracture?

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A

fracture of distal radius - compression fracture - intraarticular

21
Q

what deformity is seen with colles fracture?

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A

classical dinner fork deformity

22
Q

what are complications of colles fracture?

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A

-complex regional pain syndrome (sympathetic NS dysfunction)
-carpal tunnel syndrome
-rupture EPL tendon
-malunion / deformity

23
Q

how is a colles fracture managed?

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A

-manipulation under anaesthetic
-POP short arm cast - 4-6 weeks
-ORIF - K wires (removed when fracture healed), POP for 6 weeks

24
Q

what is the MOI of smiths fracture?

Study These Flashcards
A

patient lands w/ wrist flexion

25
what is important to note about osteoporosis & wrist fractures?
-high degree of suspicion if coleus fracture presents with low force -wrist fracture is most common fragility fracture in perimenopausal and young post menopausal women -DEXA scan needed
26
how is a smiths fracture managed?
-reduction of fracture -long arm plaster - above elbow in supination, wrist ext and elbow flex -remove POP 6 weeks and refer to physio
27
what is the MOI for Bartons fracture?
fall on extended and rotated wrist
28
what can Bartons fracture also be associated?
dislocation of wrist
29
how is Bartons fracture managed?
-ORIF to ensure stabilisation -need to restore radoiocarpal joint integrity -below elbow cast
30
what are the most common fractured carpal bones?
-scaphoid -triquetrum -trapeuzium
31
how can smiths and coleus fracture be differentiated from Bartons fracture?
bartons fracture is intraarticular and also involves carpal displacement / dislocation
32
Describe a scaphoid fracture - MOI, what pops is it common in?
-MOI - fall on outstretched hand w/ wrist extension and radial deviation -rare in younger children
33
what would a patient w/ a scaphoid fracture present with?
-radial sided pain -swelling -limited range of wrist motion -tenderness in the anatomical snuff box -pain with axial loading along thumb
34
how is a scaphoid fracture managed conservatively?
-cast immobilisation for minimum 6-8 weeks -can often need longer or transfer to a thumb spica splint after 6 weeks -can take up to 3 months to heal
35
how can a scaphoid fracture be managed surgically?
-ORIF -immobilised in thumb spica for 4-6 weeks post op
36
what is the MOI for a triquetrum?
-direct blow to the dorsum of the hand or a fall resulting in extreme dorsiflexion of the wrist
37
how is a trapezium fracture managed ?
- if non displaced immobilised in thumb spica -surgery if displaced - OORIF
38
what is a Bennetts fracture?
-a radial intraarticular fracture at the base of the 1st metacarpal phalangeal joint
39
what is a MOI for a trapezium fracture?
-direct blow to the dorsum of the hand or a fall onto a radially deviated closed fist
40
what is the MOI for a Bennetts fracture?
-FOOSH - fall on outstretched hand
41
what are the symptoms of Bennetts fracture?
- pain -swelling at the base of the thumb -limited ROM -pain and weak pinch grip -reduction and painful grip strength
42
what is a Rolando fracture?
- a comminuted intra-articular fracture at the base of the 1st MCP
43
what is an MOI for a Rolando fracture?
-punch or FOOSH with thumb in partial flexion
44
what is the most common upper limb fracture?
finger fractures
45
what are common site of finger fractures?
- base of 5th phalanx -distal phalanx of 4th
46
what is a boxers fracture & MOI?
-fracture to neck of 5th MCP -MOI - punching @ speed
47
what are the symptoms of a boxers fracture?
-reduced ROM of 5th digit -swelling and pain in hand -may or may not have malalignment
48
how is boxers fracture managed?
-casting -may to may not need closed reduction w/ physio if non displaced -surgery if displaced and immobilisation and physio
49
what is important physiotherapy treatment for forearm, wrist and finger fractures?
-POLICE -strengthening & ROM exercises - wrist fingers, thumb, elbow -manual therapy once fracture well healed -hand function - gross grip and fine grip

NMSK 2 - upper limb (16 decks)

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