UPPER LIMB FRACTURES

PART 1
CONTENTS
• SCAPULA FRACTURE
• CLAVICLE FRACTURE
• PROXIMAL HUMERUS FRACTURE
• SHAFT HUMERUS FRACTURE
• DISTAL HUMERUS FRACTURE
• OLECRANON FRACTURE
SCAPULA FRACTURE
• Mechanism : Direct blow, trauma to shoulder, fall on outstretched hand
SCAPULA FRACTURE
COMPLICATIONS

BRACHIAL
PNEUMOTHORAX
PLEXUS INJURY

ROTATOR CUFF
INJURY
 THE CLAVICLE
SPECIAL CHARACTERISTICS OF CLAVICLE :

1)FIRST BONE TO OSSIFY, LAST TO FUSE

2) STARTS AS INTRAMEMBRANOUS, THEN FINISHES AS
MEMBRANOUS OSSIFICATION
3) ONLY BONE THAT LIES HORIZONTALLY
4) NO TRUE MEDULLARY CANAL
5) SUBCUTANEOUS THROUGHOUT
ITS EXTENT
FRACTURE OF THE CLAVICLE
Medical fragment : sternocleidomastoid muscle
pulls medial fragment posterosuperiorly
Lateral fragment : pectoralis muscle and weight
of arm pulls lateral fragment inferomedially
FRACTURES OF THE CLAVICLE
COMPLICATIONS
Neurovascular
injury: Subclavian
Pneumothorax
vein & Brachial
plexus

Non-union / Shoulder
Malunion stiffness
FRACTURES OF THE PROXIMAL
HUMERUS
NEER’S
CLASSIFICATION
COMPLICATIONS

SHOULDER NEUROVASCULAR
STIFFNESS
DISLOCATION INJURY
 FRACTURES OF SHAFT OF HUMERUS

Fall on elbow
with arm Fall on hand
abducted/ with twisted
direct blow humerus

Direct Pathological
blow fracture
FRACTURES OF SHAFT OF HUMERUS
 FRACTURES OF THE DISTAL HUMERUS
• High energy , fall with flex elbow
• AO CLASSIFICATION
A: (EXTRA-ARTICULAR) - SUPRACONDYLAR
FRACTURE
B&C: INTRA-ARTICULAR – UNICONDYLAR #
- BICONDYLAR #

UNDISPLACED FRACTURES :
Backslab with 90 degrees elbow flexed

DISPLACED FRACTURES :
Open reduction internal fixation
COMPLICATIONS

NEURO
VASCULAR STIFFNESS
INJURY

HETEROTRPPHIC
OSSIFICATION
 OLECRANON FRACTURE
• Comminuted fracture: due to direct blow / fall on elbow
• Transverse break: due to traction when fall onto hand and triceps
muscle contracted

Treatment: Cast / Tension-band wiring

COMPLICATIONS

STIFFNESS NON-UNION

POST-
TRAUMATIC
OA
THANK YOU