fractures

Femoral Neck Stress Fractures

Aetiology

Athletes with increase activity / distance

Women with eating disorders /  amenorrhea

Types

Compression / inferior neck

- < 50% protective weight bear

- > 50% emergent ORIF

Tension side / superior neck

- emergent ORIF

AO Classification

Types

1. Supracondylar

2. Unicondylar

3. Intracondylar

Xrays

Supracondylar / Extra-condylar

3 types

1. Posterior Arch

Mechanism

- axial compression with hyperextension

Associations

- 50% incidence other C1/2 fracture

- i.e. ondontoid fracture

Management

- stable

- soft / philadelphia collar

2. Isolated lateral mass fracture

Mechanism

- asymmetrical axial compression / lateral bend

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 45^o angulation

- will have finger extensor lag, but will recover

History

First generation (late 70s early 80s) 

Results

Epidemiology

Usually young patients

- 15 - 40

15% compound

Aetiology

High velocity injury

- MBA

- MVA

- pedestrian v car

- fall from height

Emergency Managment

EMST principles

- need for transfusion not uncommon

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