Fraction in the arm

Fraction in the arm

1. Anatomy

   • bones
     • humerus
   • muscles
     • Anterior compartment
       • biceps
         • origin
           • long head
             • supraglenoid tubercle
           • short head
             • coracoid process
         • inserts
           • radial tuberosity
         • action
           • flexion
           • supination
           • prevent upper dislocation of shoulder joint
       • brachialis
         • origin
           • Lower 1⁄2 of the front of the humerus
           • Lateral & medial intermuscular septa
         • inserts
           • ulnar tuberosity
         • action
           • flexion
       • coracobrachialis
         • origin
           • coracoid process
         • inserts
           • Middle of medial border of the humerus
         • action
           • flexion
           • adduction
     • posterior compartment
       • ticeps
         • origin
           • long head
             • infraglenoid tubercle
           • medial head
             • Posterior surface of the lower 1⁄2 of the humerus
             • Back of lateral & medial intermuscular septa
           • lateral head
             • Upper 1⁄2 of the posterior surface of the humerus
         • insertion
           • the posterior portion of the proximal olecranon of the ulna
         • action
           • extension
   • brachial artery
     • origin
       • continuation of the axillary artery
     • course
       • downward and laterally
     • termination
       • divides
         • radial artery
         • ulnar artery
     • branches
       • profunda brachii
       • ulnar collateral
       • muscular artery
   • Nerves
     • Musculocutaneous nerve
       • pathway
         • Pierces the coracobrachialis
           • Passes diagonally below the biceps and brachialis
             • termination
               • lateral antebrachial cutaneous nerve
       • supplies
     • Radial nerve
       • pathway
         • Descends against the posterior axillary wall
           • Pass through the triangular interval
             • Runs through the Spiral groove
               • Pierces deep fascia and goes to the anterior compartment
       • supplies
     • medial nerve
       • Passes through the arm without supplying any muscle
     • ulnar nerve
       • Passes through the arm without supplying any muscle

2. Diagnosis and treatment

   • first aid
     • Stop any bleeding
     • immobilization
     • Apply ice
     • Treat them for shock
     • Call an ambulance
   • diagnosis
     • x-rays
     • CT scan
     • MRI
   • treatment
     • splints
       • to stop movement
     • braces
       • to support the bone
     • plaster cast
       • to provide support and immobilize the bone
     • traction
     • surgically inserted metal rods or plates
       • to hold bone fragments in place
     • pain relief
   • physiotherapy
     • muscle assesment
       • to restore strength and prevent complications
     • joint mobilization
       • to reverse joint stiffness
     • heat and electrotherapy
       • relieve pain and restore muscle length

3. Wrist drop

   • Radial nerve lesion
     • fingers will be fixed in the flexion position
     • muscles affected
       • lateral and medial heads of the triceps

4. bone fractures radiology

   • terms
     • disslocation
       • no more articulation- complete disruption
     • subluxation
       • Partial contact of joint components- partial dislocation
     • fraction
       • disruption of bone cortex
   • classification
     • direction
       • Transverse fracture
       • longitudinal fracture
       • oblique fracture
       • spiral fracture
     • relationship of a fracture fragments
       • Displacement
       • Angulation
         • Angles away from the normal
           • anterior or posterior
           • lateral or medial
       • shortening
         • Overlapping of the ends of the fractures
         • require surgical intervention
       • rotation
         • long bones
     • other classification systems
       • number of fractures
         • simple
         • comminuted
       • relationship of fracture with atmosphere
         • open fractures
   • Common fracture eponyms
     • Colles fracture
     • Smith fracture
     • Jones fracture
     • Boxers fracture
     • Scaphoid fracture

5. Bone fracture healing

   • two types
     • primary healing
       • features
         • No callus formation
         • two pattern
           • gap healing
           • contact healing
     • secondary healing
       • features
         • callus formation
         • Indirect fracture healing
         • Most common form
       • 4 stages
         • 1- hematoma formation
         • 2- Fibrocartilaginous Callus Formation
         • 3- Bony Callus Formation
         • 4- Bone Remodeling
     • determined by
       • stability
       • motion
         • if mobile
           • secondary
   • features
     • complex healing process
     • doesn't form a fibrous scar
   • factors that slow down healing
     • infection
     • reduced blood supply
     • age
     • steroids usage