Orthopaedics - Humeral Fractures (Ny!)

Front 1

The humerus:
- is a long bone
- does not develop on a cartilaginous model
- growth in length occurs at the epiphyses
- there are no nutritional holes

Back 1

The humerus:
- is a long bone+
- growth in length occurs at the epiphyses+

Front 2

Paralysis of the radial nerve:
- there is weakening of the extensors of the forearm and hand
- always irreversible
- frequent in fractures of humerus shaft
- it is only iatrogenic injury

Back 2

Paralysis of the radial nerve:
- there is weakening of the extensors of the forearm and hand+
- frequent in fractures of humerus shaft+

Front 3

Distal humerus:
- consist of two columns
- trochlea humeri is part of the condyle of humerus
- fossa olecrani is situated on ventral part of distal humerus
- medullary canal reaches up to trochlea humeri

Back 3

Distal humerus:
- consist of two columns+
- trochlea humeri is part of the condyle of humerus+

Front 4

Fat pad sign:
- is a picture of fat bodies on the X-ray of the elbow
- seen on dislocation of fat bodies in intraarticular injuries of the distal humerus
- is X-ray of the elbow in obese patients
- is always a sign of comminuted fracture of the distal humerus

Back 4

Fat pad sign:
- is a picture of fat bodies on the X-ray of the elbow+
- seen on dislocation of fat bodies in intraarticular injuries of the distal humerus+

Front 5

Trochlea humeri:
- carries the articular surface for olecranon ulnae
- form part of condyle of the humerus
- there is not covered with cartilage
- cannot be seen on the X-ray of the elbow

Back 5

Trochlea humeri:
- carries the articular surface for olecranon ulnae+
- form part of condyle of the humerus+

Front 6

Nonunion of the humerus:
- no sign of healing of the fracture within six months
- cannot be seen when using nailing
- re-osteosynthesis and bone grafting are the solution
- is total distal humerus replacement

Back 6

Nonunion of the humerus:
- no sign of healing of the fracture within six months+
- re-osteosynthesis and bone grafting are the solution+

Front 7

LCP implants:
- rigid connection of head of screw into the plate
- suitable in osteoporotic fracture
- unsuitable in comminuted fractures
- it is not possible to use minimally invasive approach

Back 7

LCP implants:
- rigid connection of head of screw into the plate+
- suitable in osteoporotic fracture+

Front 8

Lateral X-ray projection of the elbow:
- use to evaluate radiohumeral joint
- cannot evaluate dislocation in elbow
- is not commonly used
- elbow is flexed to 90 degrees

Back 8

Lateral X-ray projection of the elbow:
- use to evaluate radiohumeral joint+
- elbow is flexed to 90 degrees +

Front 9

Lateral approach to the humeral shaft:
- in nowadays is not used
- it is made in radial intermuscular septum
- it is not necessary to prepare the radial nerve
- it is made mostly with extremity on the auxiliary table

Back 9

Lateral approach to the humeral shaft:
- it is made in radial intermuscular septum+
- it is made mostly with extremity on the auxiliary table+

Front 10

Intramedullary nailing of humeral fractures:
- we have antegrade and retrograde nailing
- has advantage of less invasivity
- nonunion never occurs
- paralysis of the radial nerve never happens

Back 10

Intramedullary nailing of humeral fractures:
- we have antegrade and retrograde nailing+
- has advantage of less invasivity+

Front 11

Musculus coracobrachialis:
- is innervated by radial nerve
- causes flexion of the forearm
- belongs to anterior part of muscle group of the arm
- is a forearm muscle

Back 11

Musculus coracobrachialis:
- causes flexion of the forearm+
- belongs to anterior part of muscle group of the arm+

Front 12

X-ray after osteosynthesis is made mostly:
- postoperatively and 2nd, 6th, 12th week and after 3, 6 and 12 month
- two standard projection
- mostly irregularly
- X-ray in operating room after osteosynthesis is sufficient

Back 12

X-ray after osteosynthesis is made mostly:
- postoperatively and 2nd, 6th, 12th week and after 3, 6 and 12 month+
- two standard projection+

Front 13

Heterotopic ossifications:
- pathological radiopaque formation around the joints
- help to stability of the fracture
- brain injury do not increase their incidence
- prostaglandin PGE 2 is a mediator of ossification

Back 13

Heterotopic ossifications:
- pathological radiopaque formation around the joints+
- prostaglandin PGE 2 is a mediator of ossification+

Front 14

Transposition of the ulnar nerve:
- is a part of posterior approach to the distal humerus
- is an imposition of the ulnar nerve before medial epicondyle of humerus
- is suitable in humeral shaft fractures
- is resection of radial nerve and its connection with ulnar nerve

Back 14

Transposition of the ulnar nerve:
- is a part of posterior approach to the distal humerus+
- is an imposition of the ulnar nerve before medial epicondyle of humerus+

Front 15

AC dislocation Tossy 3 is:
- a lesion of acromioclavicular and coracoclavicular ligaments
- characterized by the presence of „the key symptom“
- a definite indication for conservative treatment
- lesion of only the acromioclavicular ligament

Back 15

AC dislocation Tossy 3 is:
- a lesion of acromioclavicular and coracoclavicular ligaments+
- characterized by the presence of „the key symptom“+

Front 16

Tuberculum majus humeri:
- is situated medially to the small tubercle
- musculus supraspinatus has its insertion here
- m. teres minor and m. infraspinatus has not their insertion here
- forms lateral part of humeral head

Back 16

Tuberculum majus humeri:
- musculus supraspinatus has its insertion here+
- forms lateral part of humeral head+

Front 17

Collum chirurgicum humeri:
- is narrow place under the great and small tubercles
- predilection site of fractures
- is situated intraarticulary
- can be seen only on CT

Back 17

Collum chirurgicum humeri:
- is narrow place under the great and small tubercles+
- predilection site of fractures+

Front 18

The rotator cuff:
- m. supraspinatus is a part of rotator cuff
- m. deltoideus is a part of rotator cuff
- is important for stabilization and function of the shoulder joint
- is not situated in the region of the shoulder joint

Back 18

The rotator cuff:
- m. supraspinatus is a part of rotator cuff+
- is important for stabilization and function of the shoulder joint+

Front 19

Neer´s X-ray projections:
- complex X-ray view of the shoulder joint
- they cannot be made in case of allergy to contrast medium
- comprise scapular, axillary and anteroposterior projections
- they are a combination of axillary and thoracic projections

Back 19

Neer´s X-ray projections:
- complex X-ray view of the shoulder joint+
- comprise scapular, axillary and anteroposterior projections+

Front 20

Osteosynthesis of the proximal humerus fractures:
- is performed in about 20 % of these fractures
- is indicated only for biologically young people
- is not indicated for open fractures
- mostly using LCP implants

Back 20

Osteosynthesis of the proximal humerus fractures:
- is performed in about 20 % of these fractures+
- mostly using LCP implants+

Front 21

Locking compression plate:
- are classified as „internal fixator“
- it is possible to use minimally invasive technique
- osteoporotic fractures are not indicated
- are used only on the upper extremity

Back 21

Locking compression plate:
- are classified as „internal fixator“+
- it is possible to use minimally invasive technique+

Front 22

Beach chair position:
- position of the patient during surgery of the shoulder joint
- position of the patient during CT examination of the shoulder joint
- improves visibility during surgery of the shoulder joint
- unsuitable in total proximal humerus replacement

Back 22

Beach chair position:
- position of the patient during surgery of the shoulder joint+
- improves visibility during surgery of the shoulder joint+

Front 23

Codman classification:
- divides proximal humeral fractures in four fragments
- is the basis for Neer classification
- concerns only open fractures of the proximal humerus
- concerns only osteoporotic fractures

Back 23

Codman classification:
- divides proximal humeral fractures in four fragments+
- is the basis for Neer classification+

Front 24

AO classification of the proximal humerus fractures:
- complexity of the fracture increases from A type to C type
- C type has a higher risk of avascular necrosis of the humeral head
- not used in practice
- A type involves comminuted fracture of the joint surface of the humeral head

Back 24

AO classification of the proximal humerus fractures:
- complexity of the fracture increases from A type to C type+
- C type has a higher risk of avascular necrosis of the humeral head+

Front 25

An injured rotator cuff:
- is not require treatment
- requires full reparation for good shoulder joint function
- the most common symptom is a pain
- suture of rotator cuff is contraindicated in osteoporotic bone

Back 25

An injured rotator cuff:
- requires full reparation for good shoulder joint function +
- the most common symptom is a pain+