Fracture in the arm

Fracture in the arm

1. Anatomy of the arm

   • Bones
   • Muscles
   • Nerves, Arteries, veins

2. BONE FRACTURE

   • definition
     • is a medical condition in which there is a damage in the continuity of the bone
   • Signs and symptoms
     • Pain, swelling, tenderness, deformities, limit ROM, stepping, crepitus
   • Types
     • Open or closed
       • According to the skin
       • Open fracture can lead to bone infection
     • Displaced or non displaced
     • Greenstick
       • A portion of the bone is broken
     • Spiral
       • Helical in shape
     • Transverse
       • Horizontal straight line
     • Oblique
       • sloped pattern
     • Comminuted
       • Breaks in small pieces
     • Buckled
       • Segments forced into each others
     • Pathologic
       • Ex: osteoporosis
     • Stress
       • caused by overusing
     • Complicated
       • When it cause damage to internal organs
   • Investigations
     • X-ray
       • CT scan
         • MRI
           • Blood tests
             • Angiogram
               • it shows the blood vessels
           • to check the surrounding tissues and to get a clearer view
   • Management
     • First line
       • First Aid
         • D.R.A.B.C. Emergency Response
         • Immobilize the fracture
           • Splinting the fracture
         • Reduce Swelling
         • Prevent further Injury
         • Check for complications
         • Stop any bleeding
     • Second line
       • Reduction
         • Closed Manipulation
         • Continuous Traction
         • Open Reduction
       • Immobilization
         • Conservative
           • POP-slings–traction–collar & cuff
         • External fixation
           • Bone fragments held by external scaffolding
         • Internal fixation
           • screw – plates – nails -wires
       • Rehabilitation

3. Trauma mechanisms

   • Low energy trauma
     • Simple falls, twisting injuries and sport injuries
   • High energy trauma
     • Motor vehicle and motorcycle crashes

4. Bone Healing

   • Stages
   • Factors That Influence Bone Healing
     • Infection
     • Anemia and hypoxia
     • Age and health status
     • Soft tissue injury
     • Chemical or thermal burns
     • Inadequate immobilization

5. Wrist drop

   • an injury to the radial nerve resulting in impaired nerve function causing radial nerve palsy.
   • Signs and symptoms
     • Numbness behind the hand and forearm
     • inability of the patient to bend the wrist backwards or straighten the thumb and fingers
     • persistent pain in the forearm or elbow
   • Muscles affected
     • All extensor and supinator mucles are paralyzed
   • Nerves affected
     • Radial nerve
   • Management
     • First line management
     • Surgery
       • to repair the radial nerve
   • No extinsion of elbow

6. Conditioning

   • Classical
   • Operant
     • Reinforcement
       • Positive
       • Negative
         • Escape
         • Avoidance
     • Punishment
       • Positive
       • Negative
   • type of associative learning when a stimulus becomes associated with a consequence.

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