Presentation -wrist drop -painless movement of humerus shaft fracture.
Examination: -Motor: Wrist drop Inability to extend the extensor pollicis, wrist, fingers. Wasting of 1st web space dorsally
-Sensory: Loss of sensation over the dorsum aspect of the forearm, anatomical snuff box.
-Reflexes: Nil
Find cause: -evidence of fracture at the humerus -non union -malunion -laceration scar at dorsum aspect of the arm.
Rule out: -Median n. injury -Ulna n. injury
Common questions: 1.What is non union. -when bone/fracture fails to unite within expected time, with the evidence of cessation of fracture healing.
2.Type of non union. -Hypertrophic and atrophic
3.Features of non and delayed union -clinical and radiological -clinical: Painless movemennt at fracture site. -Radiological: Present of fracture line, sclerosis of fracture ends, closure of the medullary cavity, tapering of bone ends
4.Causes of non union. -5 i's -interposition, infection,intact fellow bone,inadequate immobilization,insufficiency of blood supply.