9. Patient preparation
● The patient is preferably erect
● The patient is back is against the image receptor
● The affected arm is abducted and centered to the
upright detector.
● If possible, the arm is slight externally rotated to
mimic the true anatomical position
11. Cassette size
● IR size - lengthwise (large enough to
include entire humerus) For larger
patient, 35 x 43 cm (14 x 17 inches)
may be needed to place cassette
diagonally to include both joints. For
smaller patient, 30 x 35 cm (11 x 14
inches)
12. Positioning
Antero posterior - Supine
Position of patient and cassette
1. The patient lies spine on the X-ray tube, with the
unaffected side raised and supported on pad.
2. The cassette is positioned under the effected
limb and adjusted to include the shoulder and
elbow joint.
3. The arm is slightly abducted and the elbow joint
is fully extended, so that the posterior aspect of
the upper arm is an contact with the cassette.
4. They are is adjusted to ensure that the medial
and lateral epicondyles are equidistant from the
cassette.
5. The forearm is immobilized using a sandbag.
13. Direction and centring of the X-ray beam
● The vertical central ray is
centred to a point midway
between the shoulder and
elbow joint
14. Lateral-supine
Position of patient and cassette
1. From the antero posterior position, the elbow is flexes to 90
degree.
2. The arm is abducted and them medially rotated through 90
degree to bring the medial aspect of the arm, elbow and
forearm in contact with the table.
3. The cassette placed under the arm and adjusted in include
both the shoulder and the elbow joint.
4. The humerus is adjusted to ensure that the medial and lateral
epicondyles of the humerus are superimposed.
5. The forearm is immobilized using a sandbag,
15. Direction and centring of the X-ray beam
● The vertical central ray
is centred to a point
midway between the
shoulder and elbow joint
17. Procedure
Open reduction and internal fixation (ORIF) is a
type of surgery used to stabilize and heal a
broken bone. You might need this procedure to
treat your broken arm. The humerus is the bone
in the upper part of your arm. Different kinds of
injury can damage this bone, causing it to
fracture into 2 or more pieces
18. Radiation safety
● Basic knowledge in radiation physic and
radiation biology specific training in
equipment, training in radiation protection,
awareness of the hazard of radiation
exposes both to patient, radiology
personnel & monitoring requirements and
essential
19. Practical points
It is best to show the patient how you want they arm to
rest for the projection.
Often, you will have to rotate the light beam
diaphragm to be algued with the
Long axis of the humerus
20. Conclusion
A majority of minimally displaced
fractures can be treated
conservatively with early physical
therapy. Treatment for displaced
fractures should consider the patient's
level of independence, bone quality,
and surgical risk factors.
