VARIOUS COMMON FRACTURES AND DISLOCATIONS INVOLVING SPECIAL NAMED ONES OF UPPER LIMB

1. FRACTURES AND
DISLOCATIONS OF UPPER
LIMB

2. INTRODUCTION
Break in the structural continuity of a bone
If the underlying skin remain intact - CLOSED (Simple
fracture)
If skin or one of the body cavities is breeched -
OPEN(Compund fracture)
FRACTURE

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8. COMMON AND
UNCOMMON FRACTURES
OF UPPER LIMB

9. CLAVICLE FRACTURE
• Fracture of clavicle is the most common skeletal
injury during birth and childhood.
• Most common site of clavicle fracture is at the
junction of its medial 3/5 and lateral 2/5 junction.
• The optimal radiographic assessment include
AP veiw with 10-15 degree cephalic tilt.
• Incidence of
middle 1/3 rd > lateral 1/3rd> medial 1/3rd

10. Neurovascular damage
Malunion
Non union
Degenerative arthritis
Post traumatic osteoblasts
COMPLICATIONS OF CLAVICLE FRACTURES

11. SHOULDER DISLOCATION
• 1. Anterior - Most common type
• Mechanism is abduction + external rotation
• 2. Posterior - Mechanism is adduction + internal rotation
• More common during seizures and ECT
• Empty glenoid and light bulb sign will seen
• 3. Inferior - due to hyperabduction
3 TYPES

12. Anterior Posterior Inferior

13. Most common complication is recurrence.
Recurrent shoulder dislocations may
lead to
BANKART LESION
And
HILL SACHS LESION

14. PROXIMAL HUMERUS FRACTURE
• Most common fracture of humerus.
• Higher incidence in elderly.
• MECHANISM:- Most commonly fall on
outstretched arm.

16. HUMERAL SHAFT FRACTURES
• MECHANISM : Mainly direct trauma and
sometimes indirect trauma such as fall on
outstretched hand.
• Radiographic evaluation :
• AP and Lateral view of Humerus
• Traction radiographs may be indicated for
hard to classify secondary to severe
displacement or a lot of communition.

17. HOLSTEIN -LEWIS FRACTURE
• Spiral fracture of the Distal 1/3 rd of humerus.
• May entrap or lacerate radial nerve.

19. SUPRACONDYLAR FRACTURE HUMERUS
• Most common humeral fracture in children.
• 3 BPR is maintained.
• Common complications :
• 1. Neurovascular injury (AIN is most common nerve
involved)
• 2. Malunion
• 3. Compartment syndrome
• 4. Volkmann’s ischemic contracture.
• 5. Myosotis ossificans

20. 3 PBR is not preserved in Lateral or Medial Epicondilar fractures of Humerus.

21. FRACTURES OF RADIUS AND ULNA
• Fracture of proximal
1/3 rd of ulnar shaft
with radial head
dislocation.
• Most common
injured nerve is PIN
MONTEGGIA FRACTURE

22. FRACTURES OF RADIUS AND ULNA
• Also known as Reverse
Monteggia or Piedmont’s fracture
• Fracture of Radius shaft at
junction middle and distal 1/3rd
with distal radio ulnar joint
disruption
GALEAZZI’S FRACTURE

23. FRACTURES OF RADIUS AND ULNA
• Isolated fracture of shaft of ulna.
• Usually a defence injury.
NIGHTSTICK FRACTURE

24. FRACTURES OF RADIUS AND ULNA
• Most common fracture in
children.
• It is an incomplete unicortical
fracture seen in forearm
bones(more commonly in
radius) with concave-cover
deformity.
GREENSTICK FRACTURE

25. FRACTURES OF RADIUS AND ULNA
TORUS FRACTURE

27. COLLES FRACTURE
• Extra articulate fracture of distal end of Radius with dorsal /
posterior displacement of distal fragment.
• Most common complication is Finger stiffness> Malunion(Dinner
fork deformity)

29. SMITH’S FRACTURE
• AKA Reverse colles fracture.
• It is Extra articular fracture of distal end of Radius with
anterior/volar displacement of distal fragment.
• Most common complication is Malunion(Garden spade
deformity)

32. CHAUFFER FRACTURE
• Intra articular fracture of distal end radius.
• Radio-styloid fragment seen with normal radio-
scaphoid joint anatomy.

34. BARTON’S FRACTURE
• Intra articular fracture of distal end of radius.
• No Radios-styloid fragment seen.
• Radio-scaphoid joint subluxation.

36. SCAPHOID FRACTURE
• Most common carpal bone fracture.
• Most common fracture due to fall on outstretched hand in adults.
• Scaphoid forms floor of anatomical snuff box and it has retrograde blood flow.
• Most common site of fracture is waist of scaphoid.
• Most common complication is Non union >> Avascular Necrosis.
• X-Ray is taken in Oblique and PA in 15 degree Ulanar deviation.

40. BENNET’S FRACTURE
• Intra articular fracture of
1st metacarpal
• Oblique fracture line.
• More displaced.

41. ROLANDO’S FRACTURE
• Intra articular fracture of 1st
metacarpal.
• T / Y shaped comminuted
fracture.
• Less displaced

42. BOXER’S FRACTURE
• Fracture of neck of 5th
metacarpal.
• Commonly seen in boxers.

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