FRACTURES AND dislocation of upperl.pptx

FRACTURES AND DISLOCATIONS IN THE UPPER LIMBS

1. FRACTURES AND DISLOCATIONS IN THE UPPER LIMBS BABALOLA O M

2. HIGHLIGHTS CLAVICLE SHOULDER HUMERUS ELBOW FOREARM RADIUS HAND The objectives are that we have basic knowledge of treatment and complication of simple common fractures and institute first aid and conservative treatment for common fractures and dislocations

3. CLAVICLE MIDDLE 3RD COMMONEST, THEN outer 3 rd Fall on outstretch arm The only link of the UL to the trunk Most are managed conservatively – arm sling and analgesics Communited fracture, widely displaced or overriding are indications for surgery Subclavian vessel damage morbidity/mortality Pnuemothorax

4. Acromioclavicular joint injury Surgery treatment for d

5. Shoulder dislocation Most common joint dislocation Anterior most common( opp hip dislo ) – trauma, ligament laxity, Posterior dislocation – seizure, electric shock (2%) – usually missed Loss of shoulder bulge Inability to move the limb Close reduction = Simpson, Hippocratic, korcher Immobilize – 3wk <30yr, 1wk>30yr, to prevent recurrent dislocation and stiffness

6. Reduction technique – Hippocratic and simpson

7. complication Rotator cuff tear Axillary nerve damage Missed dislocation Recurrent dislocation Fracture dislocation Vascular damage

8. Humeral fracture Proximal Midshaft Distal Most commonly traumatic but a common site for metastatic pathological fracture eg breast cancer Commonly assoc peripheral nerve damage – radial common, ulna and median Nerve Clinical presentation of nerve palsy must be mastered. – motor and sensory

9. Prox humerus Neers classification Non-operative Operative Arthroplasty Cx – axillary N palsy test

10. Humeral shaft Non-operative – U slab Operative Loss of reduction Open fracture Vascular injury/nerve injury Polytrauma Pathological fracture

11. Supracondylar fracture Intra-articular operative

12. ELBOW DISLOCATION- mostly posterior Stiff elbow, hetetr calc are complications close reduction and immobilization in cast

13. Fracture dislocation of the elbow Dislocation – usually posterior Fracture dislocation – unstable elbow, needs surgery

14. Fracture olecranium Avulsion fracture ORIF – TBW, P/S

15. Forearm fracture Both bone fracture always Unstable fracture ORIF Nerve damage Montagea fracture Galazzi fracture

16. Fracture dislocations of forearm monteggia galleazzi

17. Distal radial fracture

18. Distal radial fracture Colles fracture – extra articular, 1 inch, dorsal angulation and radial deviation. Called dinner fork deformity –elderly osteoporotic. Abraham colles Barton fracture – intra-articular, volar Smith fracture – opp colles

19. Different mx of colles

20. COMPLICATION OF COLLES’ FRACTURE CARPAL TUNNEL SYNDROME MALUNION MEDIAN NERVE PALSY RUPTURE EXTENSOR POLLICIS LONGUS TENDON

21. Carpal injury

22. Scaphoid fracture – most common carpal fracture, prone to non-union, TENDERNESS IN THE ANATOMICAL SNUFF BOX, MISSED X-RAY DIAGNOSIS

23. Perilunate dislocation

24. Metacarpal fracture – mostly managed conserve unless severe angulation and rotation

25. BENNETT’S FRACTURE FRACTURE BASE OF THE FIRST CARPAL – THUMB INTRA-ARTICULAR INSTABILITY CMC JNT NEEDED FOR NORMAL HAND FUNCTION – GRASPING, PINCHING CRPP K-WIRE CX- STIFFNESS, OA CMC JNT

26. MALLET FINGER RUPTURE OF THE EXTENSOR TENDON RX - MALLET SPLINT This Photo by Unknown Author is licensed under CC BY-SA