Tutorial 2- Upper Limb Fractures ( Datin Vasanthie ) Pre

A 14-year-old football player sustains a direct blow to his forearm. Imaging reveals a distal third fracture of the radius and a dislocated ulna head at the wrist. What is this fracture?

• Galeazzi

• Greenstick

• Chauffeur

• Monteggia

A 5-year-old boy falls off a swing and lands on his elbow. X-rays show a Gartland 3 supracondylar fracture of the humerus. Which of the following is the most urgent indication for surgical intervention?

• Posterior displacement of the fracture

• Median nerve injury

• Limited range of motion

• Brachial artery injury

A 20-year-old rugby player lands awkwardly on an outstretched hand during a match. On examination, there is tenderness over the distal forearm, and an x-ray reveals a ventrally angulated distal radius fracture approximately 1 cm from the joint surface. What is this fracture ?

• Colles'

• Smith's

• Monteggia

• Galeazzi

A 23-year-old construction worker presents with severe pain, swelling, and tightness in the forearm following a crush injury. Despite morphine, the pain is worsening. Passive extension of the fingers causes extreme discomfort. What is the most likely diagnosis?

• Compartment syndrome

• Brachial artery rupture

• Crush syndrome

• Radial nerve palsy

A 12-year-old boy presents to ED after tripping and falling. X-ray shows a displaced midshaft humerus fracture. Neurological exam reveals wrist drop. Which nerve is most likely injured?

• Ulnar nerve

• Musculocutaneous nerve

• Median nerve

• Radial nerve

A 25-year-old man presents with a painful wrist after a fall on an extended wrist during skateboarding. He has localized tenderness over the anatomical snuffbox. Initial radiographs are inconclusive. What should be the next best step in management?

• Immobilise in a thumb spica and repeat x-ray in 10-14 days

• Immediate surgical fixation

• MRI wrist

• Reassure and discharge

A 16-year-old girl has a seizure at school. After the event, she is found holding her left shoulder, which is painful and internally rotated. What is the most likely shoulder injury following a seizure?

• Posterior glenohumeral dislocation

• Anterior glenohumeral dislocation

• Clavicle fracture

• Acromioclavicular joint dislocation

A 68-year-old woman presents with left Colle's fracture. What is the most appropriate management?

• Below elbow POP cast

• Above elbow POP cast

• Plating

• Intramedullary nailing

A 9-year-old boy falls while climbing a tree and lands on his elbow. X-ray reveals a fracture of the proximal ulna with anterior dislocation of the radial head. What is this fracture?

• Smith's

• Colles'

• Monteggia

• Galeazzi

 A 24-year-old man presents to the emergency department after a fall. He is grasping his right shoulder and is in obvious pain. An anteroposterior x-ray is ordered, which shows that the humeral head is dislodged from the glenoid cavity of the scapula anteriorly. 

Given the likely diagnosis, what is the most appropriate initial management?

• Kocher's technique reduction   

• Intra-articular lidocaine

• Shoulder immobilisation

• Intra-articular lidocaine and intravenous morphine