SUBJECT EMERGENCY

SUBMITTED TO DR BAREERA AMJAD

SUBMITTED BY MAHEEN FAROOQ

ROLL NO 1410

DATE 17-JUNE-2019

TOPIC

NAME OF FRACTURES OF UPPER LIMB WITH GIRDLES AND

LOWER LIMB WITH GIRDLES

UPPER LIMB

1-SHOULDER GIRDLE

Trauma to the shoulder is common. Injuries

range from a separated shoulder resulting from a fall onto the
shoulder to a high-speed car accident that fractures the
shoulder blade (scapula) or collarbone (clavicle).

Anatomy

The shoulder is made up of three bones:

 Scapula (shoulder blade)
 Clavicle (collar bone)
 Humerus (arm bone)
These bones are joined together by soft tissues (ligaments, tendons,
muscles, and joint capsule) to form a platform for the arm to work.

The shoulder is made up of three joints:

  Glenohumeral joint
 Acromioclavicular joint
 Sternoclavicular joint

The shoulder also has one articulation, which is the relationship

between the scapula (shoulder blade) and the chest wall.

Types of Shoulder Injuries

There are many types of shoulder injuries:

 Fractures are broken bones. Fractures commonly involve
the clavicle (collar bone), proximal humerus (top of the
upper arm bone), and scapula (shoulder blade).
 Dislocations occur when the bones on opposite sides of a
joint do not line up. Dislocations can involve any of three
different joints.
o A dislocation of the acromioclavicular joint
(collar bone joint) is called a "separated
shoulder."
o A dislocation of the sternoclavicular joint
interrupts the connection between the clavicle
and the breastbone (sternum).
o The glenohumeral joint (the ball and socket joint
of the shoulder) can be dislocated toward the
front (anteriorly) or toward the back
(posteriorly).
 Soft-tissue injuries are tears of the ligaments, tendons,
muscles, and joint capsule of the shoulder, such as rotator
cuff tears and labral tears.

Shoulder Dislocations
 Anterior dislocations of the shoulder are caused by the arm
being forcefully twisted outward (external rotation) when
 the arm is above the level of the shoulder. These injuries can
occur from many different causes, including a fall or a direct
blow to the shoulder.
 Posterior dislocations of the shoulder are much less
common than anterior dislocations of the shoulder.
Posterior dislocations often occur from seizures or electric
shocks when the muscles of the front of the shoulder
contract and forcefully tighten.

Shoulder Separations
Dislocations of the acromioclavicular joint can be caused by a fall onto
the shoulder or from lifting heavy objects. The term "shoulder
separation" is not really correct, because the joint injured is actually
not the true shoulder joint.

 Proximal Humerus Fracture

 Scapular Fracture
 Shoulder Separation (Acromioclavicular Joint Separation)
 Shoulder Dislocation (Glenohumeral Joint Dislocation)
 Clavicle Fractures
 Proximal Humerus Fractures
 Scapula Fractures
 Shoulder Separations (Acromioclavicular Joint)
 Shoulder Dislocations (Glenohumeral Joint)
 Arm fracture
 Humerus fracture (fracture of upper arm)
 Supracondylar fracture
 Holstein-Lewis fracture – a fracture of the distal third of the
humerus resulting in entrapment of the radial nerve
HUMERUS BONE

The humerus is the long bone of your upper arm. It extends from your
shoulder to your elbow, where it joins with the ulna and radius bones
of your forearm. A humerus fracture refers to any break in this
bone.The pain from a humerus fracture often extends to either your
shoulder or elbow, depending on where the break is, and recovery
may last several weeks.There are three types of humerus fracture,
depending on the location of the break:

Proximal. A proximal humerus fracture is a break in the upper part of your

humerus near your shoulder.

Mid-shaft. A mid-shaft humerus fracture is a break in the middle of your

humerus.

Distal. Distal humerus fractures occur near your elbow. This type is usually
part of a more complex elbow injury and sometimes involves loose bone
fragments.

FOREAEM FRACTURES
The forearm consists of two bones, the radius and the ulna, with the ulna is
located on the pinky side and the radius on your thumb side.

Fractures of the forearm can occur at different levels: near the wrist at the
farthest (distal) end of the bone, in the middle of the forearm or near the
elbow at the top (proximal) end of the bone. They can occur through a direct
blow (a fall on the forearm or direct impact from an object) or indirect
injury. The latter is usually secondary to landing on an outstretched arm.

Forearm fractures can occur as a single (radius or ulna only) or combined

(both bones) fracture.
When both bones are fractured at different levels and there is a joint injury
at the wrist or elbow, these are described as Galeazzi or Monteggia
fractures:

Galeazzi facture: Most often a displaced fracture in the radius and a

dislocation of the ulna at the wrist, where the radius and ulna come
together.

Monteggia fracture: Most often a fracture in the ulna and the top (head) of
the radius is dislocated at the elbow joint.

Radius fracture

 Essex-Lopresti fracture – a fracture of the radial head with

concomitant dislocation of the distal radio-ulnar joint with disruption
of the interosseous membrane [12]
 Distal radius fracture
 Galeazzi fracture – a fracture of the radius with dislocation of
the distal radioulnar joint
 Colles' fracture – a distal fracture of the radius with dorsal (posterior)
displacement of the wrist and hand
 Smith's fracture – a distal fracture of the radius with volar (ventral)
displacement of the wrist and hand
 Barton's fracture – an intra-articular fracture of the distal radius with
dislocation of the radiocarpal joint

Hand fracture

 Scaphoid fracture
 Rolando fracture – a comminuted intra-articular fracture through the
base of the first metacarpal bone
  Bennett's fracture – a fracture of the base of the first metacarpal
bone which extends into the carpometacarpal (CMC) joint [13]
 Boxer's fracture – a fracture at the neck of a metacarpal

LOWER LIMB

Tibial shaft fractures are the most common long bone fracture and the
fourth most common lower extremity fracture, following proximal femur,
metatarsal, and ankle fractures.

Pelvic Girdle

Fractures involving the structures of the pelvic girdle, which are usually
sustained in motor vehicle accidents or falls from heights, represent only a
small percentage of all skeletal injuries. Their importance, however, lies in
the significant morbidity and mortality associated with them, which is
usually caused by accompanying injury to the major blood vessels, nerves,
and lower urinary tract. Because the clinical signs of pelvic trauma may not
always be obvious, radiologic examination is essential to establish a correct
diagnosis. Fractures of the acetabulum constitute approximately 20% of all
pelvic fractures, and they may or may not be associated with dislocation in
the hip joint. Fractures of the proximal (upper) femur, occasionally referred
to as hip fractures, occur commonly in the elderly, often as a result of
minimal injury. They are seen more frequently in women than in men, with
intracapsular fractures of the proximal femur having an even higher female-
to-male ratio.

 Duverney fracture – an isolated pelvic fracture involving only the iliac

wing
 Femoral fracture
 Hip fracture (anatomically a fracture of the femur bone and not
the hip bone)
 Patella fracture
 Crus fracture
 Tibia fracture
 Pilon fracture
 Tibial plateau fracture
 Bumper fracture – a fracture of the lateral tibial plateau caused by a
forced valgus applied to the knee
 Segond fracture – an avulsion fracture of the lateral tibial condyle
 Gosselin fracture – a fractures of the tibial plafond into anterior and
posterior fragments [14]
 Toddler's fracture – an undisplaced and spiral fracture of the distal
third to distal half of the tibia [15]
 Fibular fracture
 Maisonneuve fracture – a spiral fracture of the proximal third of the
fibula associated with a tear of the distal tibiofibular syndesmosis and
the interosseous membrane
 Le Fort fracture of ankle – a vertical fracture of the antero-medial part
of the distal fibula with avulsion of the anterior tibiofibular
ligament [14]
 Bosworth fracture – a fracture with an associated
fixed posterior dislocation of the distal fibular fragment that becomes
trapped behind the posterior tibial tubercle; the injury is caused by
severe external rotation of the ankle [16]
 Combined tibia and fibula fracture
 Trimalleolar fracture – involving the lateral malleolus, medial
malleolus, and the distal posterior aspect of the tibia
 Bimalleolar fracture – involving the lateral malleolus and the medial
malleolus
 Pott's fracture
 Foot fracture
 Lisfranc fracture – in which one or all of the metatarsals are displaced
from the tarsus[17]
 Jones fracture – a fracture of the proximal end of the fifth metatarsal
 March fracture – a fracture of the distal third of one of the metatarsals
occurring because of recurrent stress
 Calcaneal fracture - a fracture of the calcaneus (heel bone)