1. Common Upper Limb Injuries in Adults Fraser J Gill August 2015

2. Hand injuries

3. Zones of Hand Be particularly wary of Zone II injuries – “No Mans Land”

4. Subungal Haematoma

5. Nail Avulsion Management Options?

6. Tuft Fracture Management determined by displacement and whether open or closed

7. Mallet Finger Bony vs Non-bony

8. Phalangeal fractures Consider rotation, displacement, articular involvement and potential instability

9. Dislocated Fingers Reduction usually uncomplicated Assess stability, splint and always re-x-ray!

10. Fractured neck of 5 th metacarpal – “Boxer’s” fracture Significant angulation (up to 70°) acceptable

12. Fracture of base of thumb metacarpal “Bennett’s fracture”

13. Fracture of base of thumb metacarpal “Rolando fracture”

14. Ulnar Collateral Ligament Tear

15. Common Carpal Injuries

16. Scaphoid Fractures

17. Risk of avascular necrosis in fractures involving waist or proximal pole

18. Lunate Dislocation

19. Perilunate Dislocation

20. Lunate vs Perilunate Dislocation

21. Triquetral Fracture

22. Common Injuries of Wrist and Forearm

23. Fracture of distal radius “Colles’ Fracture” – Dorsal angulation and displacement

24. Fracture of distal radius “Smith’s’ Fracture” – Volar/Palmar angulation and displacement

25. Radial Styloid Fracture “Hutchison’s” or “Cheuffeur’s” Fracture (note also fracture of ulnar styloid)

26. Intra-articular fracture of the volar/palmar aspect of distal radius “Barton’s Fracture”; there is also a less common dorsal variant

27. Fractured Shaft of Radius and Ulna

28. Isolated fracture of ulnar shaft “Nightstick” Fracture: Classically a defensive injury

29. Galeazzi Fracture-Dislocation Complex Fracture of radial shaft with associated dislocation of ulnar head

30. Common Injuries of the Elbow

31. Fractured radial neck

32. Fractured radial head

33. Fracture of olecranon process

34. Dislocation of Elbow Joint Most commonly posterior Associated fractures may be only be evident on post-reduction x-ray

35. Monteggia Fracture-Dislocation Complex Fracture of ulnar shaft with associated dislocation of radial head

36. Common Humeral Fractures

37. Distal Humerus Fractures Much less common in adults compared to children Brachial artery and median/ulnar nerves at risk

38. Humeral Shaft Fractures Transverse vs Spiral Radial nerve is at risk

39. Common Shoulder Injuries

40. Anterior Glenohumeral Dislocation

41. Posterior Glenohumeral Dislocation Consider axillary projections if in doubt

42. Inferior Glenohumeral Dislocation “Luxatio Erecta” - Rare

43. Fractured Surgical Neck of Humerus

44. Fracture of Greater Tuberosity

45. Fractured Glenoid

46. Scapular Fracture High energy injury

47. Acromiooclavicular Disruption

48. Acromioclavicular Disruption

49. Clavicle Fractures (spot the other diagnosis)

50. Rotator Cuff Tears

51. Questions?? Summary: Examine and document findings Joints above and below injury Neurovascular status Seek advice Senior ED medical staff Nurses ENPs Orthopaedic practitioners Specialty colleagues Radiographers Remember patient advice leaflets