Upper Extremities

Question 1

Colles fracture

Answer 1

The most common fracture of the forearm is a complete transverse fracture of the distal 2 cm of the radius. The fracture results from forced dorsiflexion of the hand, usually as the result of trying to break a fall by outstretching the upper limb. This clinical condition is often referred to as a ”dinner fork”deformity because a posterior angulation occurs in the forearm just proximal to the wrist and the normal anterior curvature of the relaxed hand.

Question 2

Monteggia fracture

Answer 2

dislocation of the proximal radioulnar joint in association with a forearm fracture (ulna)

Question 3

Posterior dislocation of the elbow joint

Answer 3

occurs when children fall on their hands with their elbow flexed. The distal end of the humerus is driven through the weak anterior part of the fibrous layer of the joint capsule as the radius and ulna dislocate posteriorly. The ulnar collateral ligament is often torn, and an associated fracture of the head of the radius, coronoid process or olecranon process of the ulna may occur. Injury to the ulnar nerve may occur, resulting in numbness of the little finger and weakness of flexion and adduction of the wrist.

Question 4

Radial Head Subluxation (“pulled elbow”)

Answer 4

reduces spontaneously or

with rapid supination. Can occur when you swing a child by the arms

Question 5

elbow tendinitis

Answer 5

is a painful musculoskeletal condition that may follow repetitive use of the superficial extensor muscles of the forearm. Repeated forceful flexion and extension of the wrist strain the attachment of the common extensor tendon, producing inflammation of the periosteum of the lateral epicondyle (lateral epicondylitis).

Question 6

Biceps tendinitis

Answer 6

inflammation of the long head tendon of the biceps.

Question 7

The following parts of the humerus are in direct contact with the indicated nerves, which may be injured when the associated part of the humerus is fractured:

• Surgical neck
• Radial groove
• Distal end of humerus
• Medial epicondyle

Answer 7

• Surgical neck: axillary nerve.
• Radial groove: radial nerve.
• Distal end of humerus: median nerve.
• Medial epicondyle: ulnar nerve

Question 8

Labral tear

Answer 8

Most labral tears are the result of an injury to the shoulder. A tear in the labrum can cause pain and a catching sensation of the shoulder

Question 9

Adesive Capsulitis (frozen shoulder)

Answer 9

Frozen shoulder results from inflammation of the capsule surrounding the shoulder joint. The shoulder becomes painful, causing the patient not to want to move it; but without motion the shoulder problem worsens. Restriction of movement promotes the formation of adhesions, which worsens the condition.

Question 10

Bursitis

Answer 10

Bursitis is the result of increased fluid secretion into one or more bursae that is associated with inflammation of the synovial membranes. The swelling exerts pressure on the bursae and may be very painful.