fractures

Metacarpal Fractures

Fractures

 

1.  Neck of 5th Metacarpal

2.  Metacarpal Shaft

3.  Metacarpal Head

4.  Base of Metacarpal Fracture Dislocations

5.  Base of Thumb Fractures / Bennett's / Rolanda

 

1.  Neck of 5th Metacarpal Fracture

 

Non operative Management

 

Accept 45o angulation

- will have finger extensor lag, but will recover

Clavicle Fractures

Clavicle Fracture Displaced

Mechanism

 

Usually a direct blow 

- less commonly a fall on the outstretched hand

 

RTA / sporting accidents commonest causes

 

Can be pathological as a result of radionecrosis

- eg following radiotherapy for breast cancer.  

 

Incidence

 

Fractures of the clavicle are common

Forearm Fractures

Ossification

 

Primary

- 8 / 52 gestation radius & ulna

 

Secondary

- distal radius age 1

- distal ulna age 5

 

Non Operative Management

 

Unacceptable Position

 

< 10:  > 15o malalignment

> 10:  > 10o malalignment

 

Postreduction Positionin / Rule of Thirds 

 

Ankylosing Spondylitis

Definition

 

A HLA B27 positive, seronegative spondyloarthropathy with sacroiliac joint & spine involvement

Mainly affects the cartilaginous joints of the axial skeleton

 

Diagostic Criteria (1966 New York)

 

1. Positive X-ray Sacroiliitis

 

Sacroilitis Ankylosing Spondylitis