Upper Limb Injury

Question 1

Open fractures require

Answer 1

Emergent orthopaedic intervention

Always examine + record the neuro vascular status of the limb

Question 2

Compression fracture

Answer 2

Bone fragments pushed into eachother

Scan shows radiolucent line

Question 3

Communities fracture

Answer 3

More than 2 fragments

Question 4

Scj dislocation

Answer 4

Anterior more common

Anterior braid arm sling and fracture clinic

Posterior refer to orthopaedics

Ct mandatory

Complications- pneumothorax,injury to great vessels, trachea or oesophagus

Question 5

Ac joint injuries classification

Answer 5

1= radiographic ally normal
2= increased distance between clavicle and acromion
3=increased distance betweeen clavicle and acromion
4-6= defined by displacement

Question 6

Which class ac joint injury require operation

Answer 6

4-6

Question 7

Clavicular fracture occurs how

Answer 7

Blow to shoulder

Extreme end fractures commonly missed

Question 8

Ref freak required for which type of fracture

Answer 8

Open o,neurovascular compromise or tenting of skin

Question 9

Clavicle fracture treatmen

Answer 9

Broad arm sling

Analgesia+ iboprufen

Question 10

Clavicular fractures classified by

Answer 10

All man

Question 11

Allman classification

Answer 11

Middle1/3- 80%
Most common to fracture

Distal 1/3

Associated with ruptured cc lig
May require operation to avoid non union

Medical 1/3
Higher association with intrathoracic injury
Requires strong injury forces

Question 12

Shoulder dislocation feature

Answer 12

Most common large dislocation

Anterior 97%

Question 13

Clinical features of shoulder dislocation

Answer 13

Painful shoulder
Arm abducted and extremely rotated

Elbow flexed

Squaring loss of contour

Palpable head in intra-clavicular fossa

Always check sensation on deltoid and radial re manipulation

Question 14

Complication of shoulder dislocation

Answer 14

Axillary nerve injury

Axillary artery injury- most common vascular injury

Fractures of fumeral head

Question 15

Manipulation under anaesthesia

Answer 15

Often first dislocations can be ,manipulated under morphine or entonox alone

Always check sensation on deltoid and epradial pulse before manipulation

Question 16

Mitch’s manipulation

Answer 16

Raise patients hand whilst lying supine and externally rotate

Therapists thumb is used to push head back in place

Question 17

Problem with lockers manoeuvre

Answer 17

Prone to complications

Question 18

Neer classification

Answer 18

1- one part FaceTime
2-2 part fracture displacement of one fragment

3- 3 part fracture- displacement of 2 individual fragments of humerous

4: 4 part fracture displacement of all four segments
5: there is dislocation regardless number Of displaced segment

Question 19

Fracture surgical neck of humerous treatment

Answer 19

Broad arm sling, analgesia and refer to fracture clinic

Very communicated fracture refer to ortho

Question 20

Fracture of shaft of humerus

Answer 20

Middle third commonest

Mechanism of injury-
Direct blow
Fall on outstretched arm or elbow
Pathological fracture

Tenderness and swelling

Neurovascular damage common

Question 21

Mid shaft humerus fractures show what

Answer 21

Pain and deformity

Radial nerve injury

Question 22

Elbow dislocation complications

Answer 22

Unusual

Injury to brachial artery
Ulnar
Median and radial nerves