fractures and dislocations is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...

1. - DR.AKIF A.B

3. TIP: Remember muscle locations, it can be asked as a question for identification

4. Q. Lift off test is done for??

5. Ans. SUBSCAPULARIS MUSCLE

6. B

7. Q.Rotator Interval ??

8. Ans. Rotator interval is interval between subscapularis and
suprascapularis. Coracohumeral ligament passes through this interval

10. 1) Most common type of shoulder dislocation = Anterior type (subcoracoid> preglenoid)
2) Mechanism of injury for anterior dislocation = abduction and external rotation
3) Position of arm in anterior dislocation = abduction and external rotation
4) Position of arm in posterior dislocation = adduction and internal rotation
5) Most common joint to dislocate = shoulder
6) Least common joint to dislocate = Ankle
7) Tests for anterior shoulder dislocation = Bryant’s test
Callaway’s Test
Dugas test
Hamilton ruler test

15. Ans.
‘A’ is anterior dislocation and ‘B’ is Posterior dislocation
Explanation:
In anterior dislocation of shoulder, position of shoulder is abducted
and externally rotated and you can see that in xray i.e humerus will be
at an angle to scapula i.e abducted position.
In posterior dislocation, position of shoulder is adducted and
internally rotated, so u can see clearly in xray that humerus is straight
(adducted) and not making any angle.

16. Anterior dislocation

17. Line is straight…..so
Posterior dislocation

18. A Bankart lesion is an injury of the anterior (inferior) glenoid labrum of the
shoulder due to anterior shoulder dislocation. When this happens, a pocket at
the front of the glenoid forms that allows the humeral head to dislocate into it.

19. Hill–Sachs fracture, is a cortical depression in the posterolateral head of
the humerus. It results from forceful impaction of the humeral head against
the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.

20. Q. What is Reverse Hill sach’s Lesion??

21. Ans. It is defect in Antero medial part aspect
of humerus head in posterior dislocation of shoulder
Mnemonic: R – Reverse hill sachs
A – Anterior part of humeral head
M – Medial part of humeral head
P – Posterior dislocation

22. Q. Muscle crossing shoulder joint = Long head of Biceps
Q. Weakest portion of shoulder joint capsule = Inferior
Shoulder is weakest inferiorly but dislocations are more common
anteriorly since it is the direction of force which decides dislocation but
Never the anatomical weakness
Q. Most common early complication of = Nerve Injury
shoulder dislocation
Q. Most common Nerve Injury in = Axillary N.
shoulder dislocation

23. Treatment of choice : Reduction techniques : Kocher’s method :best
Stimson’s gravity method
Hippocratic method :old
Neglected shoulder dislocation is always managed Surgically

27. -Also known as Inferior dislocation of Shoulder.
- caused by severe hyperabduction of force.
- MC Nerve injury associated is : Axillary N.

28. Anterior Instability : F- Fulcrum test
o
C – Crank test
u
S- surprise test (Most Accurate)
Posterior Instability : Jerk Test
Posterior apprehension test
Posterior clunk test
Push-pull test
Inferior Instability : Sulcus test

29. S.No. Injury Nerve Involved
1. Shoulder dislocation Axillary
2. Fracture surgical neck humerus Axillary
3. Fracture shaft of humerus Radial
4. Supracondylar fracture AIN>Median>Radial
>Ulnar (AMRU)
5. Medial condyle humerus # Ulnar N.
6. Monteggia # Post. Interosseus N.
7. Volkman ischemic contracture Ant. Interosseus N.
8. Lunate dialocation Median N.
9. Hip dislocation Sciatic N.
10. Knee dislocation Common peroneal
N.
11. Post. Dislocation of shoulder Ulnar N.

30. -Most common bone to fracture in body.
- MC site of fracture = junction of medial 2/3rd and lateral 1/3rd
- Most common bone fractured during birth
- Treatment: Figure of 8 bandage

31. Q. Highest bony landmark in shoulder x-ray ??
a) clavicle
b) acromion
c) coracoid
d) head of humerus

32. Ans. Acromion

34. Ans.

35. -A spiral fracture of lower 3rd of humerus is k/a Holstein Lewis fracture
- MC nerve injury is : Radial N.
- Treatment : Hanging cast

36. Ossification centres :
Capitullum = 2years
Internal(medial) epicondyle = 6years
Radius Head = 4years
Trochlea = 8years
External(Lateral) epicondyle = 12years
Olecranon = 10years

38. MC elbow injury in children
(MC elbow injury in adults is : Physeal Injury)
MC type : Extension type(98%)
MC type of distal fragment displacement in Extension type: Postero-medial
with internal rotation
Medial(Internal) Rotation/ Medial Tilt/Medial shift
Impaction (proximal shift)
Dorsal displacement/ dorsal tilt
Characteristic displacements

39. -GARTLAND Classification is used for it
- Treatment : Close Reduction and K wire fixation
- MC complication : Malunion = Cubitus varus or gunstock deformity
- MC Nerve Injury : Anterior Interosseus Nerve ( A>M>R>U )
- 3 point bony relationship is maintained i.e tips of medial and
lateral epicondyle and olecranon
-MC Cause of Volkmann Ischemic
Contracture

40. 1) MILCH Classification is used
2) MC complication : Non union – leads to Cubitus Valgus
3) Treatment : Open reduction
4) Treatment of cubitus varus : Modified French Osteotomy
5) Late complication : Tardy Ulnar N. Palsy
6) 3point bony landmark is disturbed

43. Mnemonic: Lets Go For OPeration At Medical college
Lateral
condyle #
Galeazi #
Femur neck#
Olecranon #
Patella#
Articular#
( Involving joint)
Monteggia #

44. - Calf pressure during walking is = 200-300mmHg
-In compartment Sx, pain on passive stretch ( distal most joint of extremity)
is the first sign
-Peripheral pulses can be normal in compartment syndrome
- MC muscle involved in volkmann ischemic contracture :
Flexor digitorum profundus> flexor pollicis longus

45. A pulled elbow is a common injury amongst children under the age of five.
It is a result of the lower arm (radius bone) slipping out of its normal
position at the elbow joint or more accurately subluxation of annular ligament
from the head of radius
Chid holds elbow in slight flexion with elbow normal

47. Q. Treatment for Olecranon # ??

48. A. Tension Band wiring

49. -Monteggia fracture is a fracture of the proximal third of the ulna with
dislocation of the proximal radio-ulnar joint
- Bado’s classification

50. The Galeazzi fracture is a fracture of the radius with dislocation of the
distal radioulnar joint.

51. AColles' fracture is a fracture of the distal radius in the forearm with dorsal
(posterior) and radial displacement of the wrist and hand.

52. Displacement : S: Supination
L : lateral displacement
I : Impaction(proximal shift)
P: Posterior displacement
Cast : below elbow
Position: Reverse to displacement
pronation
ulnar deviation
Palmar angulation
Common in elderly menopausal females

53. Complications : 1) Joint Stiffness : Most common
2) malunion : 2nd most common
3) sudeck’s osteodystrophy
4) carpal tunnel Sx

54. Reverse of colles
Cast : Above elbow

56. -Pain in anatomical snuff box
- MC complication : Non union
- Cast : Glass holding cast

58. Mnemonic: Some Lovers Try Positions That They Can’t Handle
Proximal row
lateral to medial
Distal row
lateral to medial