Injuries To The Upper Limb Flashcards Preview

Semester 2 > Injuries To The Upper Limb > Flashcards

Flashcards in Injuries To The Upper Limb Deck (28):
1

Sprain

Stretching of the joint capsule and ligaments of a joint, which is not sufficient to cause dislocation or subluxation

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Causes of fractures

Mechanical stress / trauma

Can be due to excess force on normal bone

or normal force on weakened bone (osteoporosis, osteogenesis imperfecta, pagets)

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How is integrity if the bone maintained?

Calcium, provides rigidity.

Use/stress on the bone encourages remodelling and strengthens the bone

Collagen fibres reinforce structure of bone

4

Clinical signs and symptoms of fracture

Pain
Swelling
Tenderness
Bruising

Deformity - defining feature
Crepitus
Abnormal movement

5

Source of pain in a fracture

Bleeding due to fracture increases pressure in the bone. Sensory fibres in the periosteum which are compressed due to pressure causing pain

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Compound fracture

Fracture of the bone together with a breach of the skin, bone is exposed to the air, which may allow an infection to enter

Two types: protrusion of bone out due to fracture, bone exposed due to crushing injury

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Risks in compound fracture

Can lead to infection, site needs to be washed with saline, some tissue may need to be removed. ,

8

Complicated fracture

Fracture with damage to the surrounding soft tissues and associated structures e.g. blood vessels, nerves, viscera

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Delayed union

Bone takes longer to heal than expected (different for each bone)

10

Non-union

Bone does not unite after a fracture.
Can be due to the bone dying and becoming sclerotic. Requires surgical intervention e.g. Replacement

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Mal union

Bones join in the incorrect alignment

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Diagnosis of fractures

History, examination
CT
X-ray
MRI
Ultrasound (particularly in children)
Bone scan

13

Complication of posterior displacement of sternoclavicular joint

Compression of the subclavian. Causes ischemia of the limb

14

AC subluxation/dislocation

Caused by overuse of joint ( repetitive strain damages ligaments)

15

Why is callus formation common following clavicle fractures?

Because the clavicle is highly mobile, healing tends to form excess bone as the two ends unite. Process normally takes 6-9 weeks

16

Fracture

Breach in integrity of part or all of the bone

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Dislocation

Complete separation of articulate surfaces in a joint

Caused due to compromised joint support, excess forces through the joint, or if the joint is stressed in a position of instability

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Subluxation

Partial separation of articular surfaces of a joint

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Fracture dislocation

Dislocation where there is a fracture involving one or more or the articular joint surfaces.

Results in degenerative changes

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Complication of supra condylar fracture of humerus

Loss of anterior interosseus nerve

Damage to median nerve, loss of flexion of 1st digit (pointing finger sign)

Flexor compartment syndrome

Damage to brachial artery

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Complication of elbow dislocation

Damage to ulnar nerve, loss of muscles in the hand.

First sign is lack of flexion in terminal joints, progresses to claw hand and muscle wasting

22

Conditions which cause an increased risk of fractures

Osteoporosis - reduction of bone density due to increased osteoclast activity

Pagets disease - excessive bone remodelling results in weakened (woven) mishapen bone, increased blood flow reduces calcium levels

Osteogenesis imperfecta - insufficient or defective collagen production, bones are weakened.

23

Complications of clavicular fractures

Damage to brachial plexus
Damage to subclavian vein

24

Common sites of scapula fractures

Blade
Spine
Glenoid

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Complications of fractures at the neck of the humerus

Damage to axillary circumflex nerve and circumflex humeral arteries

26

Common sites of proximal humerus fractures

greater tuberosity
anatomical neck
surgical neck
head

27

Volkmann's ischemic contracture

Permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers

Caused following supracondylar fracture of the humerus which can lead to obstruction of the brachial artery/compartment syndrome. Fibrosis and shortening of flexor muscles causes contracture

28

Bennetts fracture

Fracture through the base of the first metacarpal

Intra-articular fracture, can result in arthritis in the thumb.

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