Fractures of Upper Limb

Zha Zhen-gang

2018-09-27

Department of Orthopaedics,
the First Affiliated Hospital of Jinan University

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 Fracture of the clavicle
 Etiology

 Pathology

 Symptoms and signs

 Diagnosis

 Complications

 Treatment

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 Etiology
Most fracture of the clavicle are
caused indirectly by fall on the
shoulder, forearm or hand with the
arm abducted.

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 Pathology

Fracture between the coraco-clavicular ligament

and the distal end of the clavicle are usually
caused by direct violence as from a blow on top
of the shoulder. Usually, there is but little
displacement, because the fragments are held in
place by the coraco-clavicular and
acromioclavicular ligaments

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Pathology

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 Symptoms and signs

Deformity in the clavicluar area;

Partial or complete loss of function of the arm

depending on whether the fracture is greenstick,
or complete.

Local pain and tenderness at the site of injury.

Crepitus is present, if the fracture is complete.

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 Diagnosis

The diagnosis is based upon the

symptoms mentioned above, along
with the roentgenographic findings.

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 Complications

Injury of the nerves of the brachial

plexus;

Injury of the subclavian vessels;

Puncture of pleural cavity or of the long;

Interference with the function of the

shoulder joint from displacement of the
outer fragment. 8
 Treatment
Close reduction and external fixation

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Operative treatment is reserved for:
Irreducible cases with marked deformity

Recent cases with injury or threatened injury of the

large blood and nerves

Cases showing marked mal-union or non-union

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 Proximal Humerus Fractures

Classifications

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Conservative treatment

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Operative treatment

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 Fractures of shafts of humerus

 Etiology

Direct violence

Indirect violence

Muscular action

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Diagnosis

 History

 Signs

 X-ray

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Radial Nerve

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Radial Nerve
Lesion

“wristdrop”
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Conservative treatment

Manipulative reduction and

external fixation

Splintage

Plaster fixation

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Operative treatment

1 、 Screws and plates

2 、 Braces

3 、 platesintramedullary nails

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Supracondylar fracture of the humerus

Anatomical

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 Classification

Extension type Flexion type 26

Direct violence
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 Clinical features and diagnosis

 History
 Swelling, pain, deformation
 X--ray

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Treatment

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 Complications

 Early stage ：
 osteofasical compartment
syndrome of forarms
Painlessness Pulselessness
Pallor Paresthesia
Paralysis
 Late stage ： elbow joint varus

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 Both-bone forearm fractures

 Etiology

Direct violence

Indirect violence

Rotation violence

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 Both-bone forearm fractures

Treatment
Manipulative reduction and external fixation
Splintage
Plaster fixation
Open reduction and internal fixation
Screws and plates
platesintramedullary nails

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 Distal radius fracture

Anatomical

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 Distal radius fracture

Etiology
 Indirect violence

Classification
 Extension type—— Colles fracture
 Flexion type——Smith fracture

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 Distal radius fracture

 Pain

 Swelling

 Dinner-fork defornity

 Dysfunction

 X － ray

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Dinner-fork deformity
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 Distal radius fracture

Treatment
Manipulative reduction
and external fixation
Splintage
Plaster fixation

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Plaster cast external immobilization
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Thank you ！