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.

5.Treatment of non union.
-ORIF & bone graft.

Labels: Short cases in orthopaedics