Injuries of the

Upper Extremity

JOSELITO T. DYCHIOCO, M.D.

Orthopaedic Surgeon
 At the end of the lecture, the student
should be able to:
• Identify and evaluate the different types of
fractures and dislocations and provide for the
initial management of the following fractures
& dislocations:
• Clavicular fractures, Shoulder dislocations,
Humeral fractures, elbow fractures-
dislocations, forearm fractures, wrist fractures
& hand fractures
• Appreciate the different types of definitive
treatment for the above fractures and
dislocations
• Identify fractures and dislocations needing
appropriate referral to orthopedic specialists
Clavicular Fracture
• Due to a fall on the
shoulder
• Occurs most often in
children
• Most common site is at
the middle 3rd
• Proximal fragment
displaced up by pull of
sternocleidomastoid
• Distal fragment displaced
down by weight of
shoulder
Clavicular Fracture
Clavicular Fracture
Clavicular Fracture
Clavicular Fracture
ACROMIO-CLAVICLUAR JOINT
DISLOCATION
TYPES OF AC JOINT DISLOCATION
X-RAY OF AC JOINT DISLOCN
Anterior Dislocation of Glenohumeral
Joint

Three Types

Subcoracoid Subglenoid Subclavicular

(most common) (uncommon)
Anterior Dislocation of Glenohumeral
Joint
Physical Examination Findings
Anterior Dislocation of Glenohumeral
Joint
Physical Examination Findings
Anterior Dislocation of Glenohumeral
Joint

AP X-ray – Subcoracoid dislocation

Anterior Dislocation of Glenohumeral
Joint
Anterior Dislocation of Glenohumeral
Joint
Anterior Dislocation of Glenohumeral
Joint
Anterior Dislocation of Glenohumeral
Joint
Anterior Dislocation of Glenohumeral
Joint
Anterior Dislocation of Glenohumeral
Joint
Fracture of Proximal Humerus
• Due to a fall or
direct trauma on
the shoulder
• Occurs most often
in older individuals
• Neer four-part
classification
1. Articular fragment
2. Lesser tuberosity
3. Greater tuberosity
4. Shaft
PROXIMAL HUMERUS FRACTURES
Fracture of Proximal Humerus

AP view
Fracture of Proximal Humerus

Lateral view
Fracture of Proximal Humerus

Axillary view
 Fracture of Proximal Humerus
Treatment:
If no fragments are displaced (stable)
Minimal immobilization
Early range-of-motion exercises
Displacement of 1 cm. or angulation of 450 of
one or more fragments
Open reduction & internal fixation
Prosthetic replacement
ORIF PROXIMAL HUMERUS FRACTURE
Fracture of Proximal Humerus
Fracture of Proximal Humerus
Fracture of Humeral Shaft
Fracture of Humeral Shaft
Fracture of Humeral Shaft
Fracture of Humeral Shaft
 Supracondylar Fracture
Two Types
Supracondylar Fracture
 Supracondylar Fracture
Closed Reduction
Supracondylar Fracture
Supracondylar Fracture
Elbow Dislocation
Elbow Dislocation
Monteggia Fracture - Dislocation
Forearm Fracture
Forearm Fracture
Forearm Fracture
Galeazzi’s Fracture
Galeazzi’s Fracture
Galeazzi’s Fracture
Monteggia’s Fracture
Monteggia’s Fracture
Monteggia’s Fracture
Monteggia’s Fracture
Colle’s Fracture
Colle’s Fracture
Colle’s Fracture
Colle’s Fracture
Colle’s Fracture
Colle’s Fracture
Scaphoid Fracture
Scaphoid Fracture
Scaphoid Fracture
Scaphoid Fracture
Scaphoid Fracture
Scaphoid Fracture
Smith Fracture
Smith Fracture
Finger Injuries
Finger Injuries
Finger Injuries
Finger Injuries
Phalangeal Fracture
Phalangeal Fracture
Phalangeal Fracture
Phalangeal Fracture
Metacarpal Fracture
Metacarpal Fracture
Metacarpal Fracture
 Thumb Fracture
Four Types
Thumb Fracture
Thumb Fracture
Thumb Fracture