Topics Discussed: musculoskeletal system; upper limb fractures and dislocations.
Sections: Injuries in the Upper Extremity, The Clavicle and Acromioclavicular Joint, Medial Clavicle Fractures, Diaphyseal Clavicle Fractures, Lateral Clavicle Injuries, Scapular Fractures, Shoulder Dislocations, Humerus Fractures, The Elbow, Supracondylar Humerus Fractures, The Medial and Lateral Condyles, Medial Epicondylar Fracture, Fracture Separation of the Distal Humeral Physis, Elbow Dislocations, Radial Head Subluxation, Fractures of the Radius and Ulna, Proximal Radius and Ulna Fractures, Diaphyseal Radius and Ulna Fractures, Distal Radius and Ulna Fractures, Physical Examination, Fractures of the Phalanges, Metacarpal Fractures, Carpal Fractures, Dislocations, References.
- The clavicle is the most common bone to be fractured in a shoulder injury.
- Small children with a clavicle fracture may present with refusal to move the arm after a fall.
- The proximal humerus epiphyseal plate is sometimes confused for a fracture.
- Children are more likely to suffer a SalterHarris type II fracture separation of the proximal humerus than a true shoulder dislocation.
- Indirect radiographic evidence of elbow fracture includes the presence of a posterior fat pad, an exaggerated anterior fat pad, and an abnormal radiocapitellar or anterior humeral line. Further evidence may be obtained from normal comparison views and oblique views.
- Supracondylar fractures of the humerus can be associated with acute and delayed neurovascular compromise and require immediate orthopedic consultation.
- Nursemaid's elbow is the most common pediatric elbow injury. X-rays are not required if there is no elbow swelling.
- Fracture separation of the distal humeral physis may be the result of physical abuse.
- Fracture of the radius or ulna requires x-ray evaluation of the elbow and wrist to determine if a Monteggia or Galeazzi fracture is present.
- The normal cascade of the resting hand shows increasing flexion from the index to little fingers and from the distal interphalangeal (DIP) joints to the metacarpophalangeal (MCP) joints...."
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