CONDITIONS TREATED
Upper Limb Fractures
Clavicle (collarbone)
These fractures are extremely common, occuring in babies (often during birth), children and adolescents (as the clavicle is weaker until adulthood), and athletes (because of the risks of being hit or falling), or during many types of accidents and falls.
Symptoms
Shoulder pain, difficulty in moving the arm, swelling and bruising around the break. May result from impact directly to the clavicle or to the outside of the shoulder or even from falling on an outstretched hand. Clavicle fractures in babies may occur during manipulation of the shoulders in the birth canal.
Diagnosis
X-ray examination will show the fracture and physical examination will check whether the nerves and blood supply around the break are intact.
Treatment
Commonly, rest with a sling to brace the shoulder will allow the clavicle to repair itself, usually within 12 weeks. In cases of severe displacement or shortening of the bone, surgery may be required.
Shoulder girdle
This is formed by the shoulder blade (scapula), the acromion and the head of the upper arm (humerus). Scapular body and neck fractures are the most common injuries, but seldom require any specific treatment other than a simple arm sling unless there is severe misalignment of the bones. However, a fractured scapula may be associated with other trauma injuries in the lung and chest area. Fractures involving the cartilage surfaces of the shoulder joint (glenoid) may, however, require surgery when the shoulder joint becomes unstable or if the fragments are far out of alignment.
Upper arm and forearm
Fractures to the upper arm (humerus) and the forearm (ulna and radius) are common and if the break is without complications, such fractures do not need surgery but may heal better with physiotherapy to ensure a full return of normal limb mobility.
Symptoms
Pain, swelling, and stiffness in the limb, with loss of full mobility and instability.
Diagnosis
Fractures may occur following a fall onto an outstretched arm, most commonly in older people with bones weakened by osteoporosis, or often as a result of motor vehicle accidents. Diagnosis may included testing to check for sensory, vascular or motor function impairment, as well as x-ray or MRI scan.
Treatment
Forearm fractures can be classified as either proximal, middle or distal and can affect one or both forearm bones, and may involve disclocation or damage of the elbow joint. Treatment of fractures in children differs from adults as the forearm bones will continue to grow after healing of the fracture (which is termed 'greenstick' fracture in children).
In adults, displaced fractures will need surgery to fix the bones internally or use intramedullary nailing. In children, however, many both-bone fractures of the forearm can be treated without open surgery.