SIGNS & SYMPTOMS OF

FRACTURE
WRIST DROP
RIDA ARIF
PHYSICAL EXAM FOR BONE
FRACTURES
IMAGING OF
NORMAL/FRACTURED ARM
BONES
 CAN NEUROMA o Praxis/Stretch?
HAPPEN AFTER o Neuroma?

PRAXIS OR o Yes as one of the causes of neuroma is trauma

which can cause damage to the nerve, resulting in
STRETCH OF THE inflammation or swelling of the nerve.

SPINAL NERVE?

(APMA, 2019)
CASE: CLOSE TO THE
BONE
SIGNS &
SYMPTOMS
• Swelling or bruising over a bone
• Deformity
• Pain which gets worse when the
area is moved/pressure
• Inability to bear weight
• Loss of function in that area
• Bone protruding from the skin –
open fractures
• Immobility

(WEBMD, 2019)
WRIST DROP/RADIAL
NERVE PALSY
• Results from acute trauma/compression of the
radial nerve
• Saturday Night Palsy, Honeymoon Palsy, Crutch
Palsy
• Supplies: Extensor muscles of the wrist and
fingers + triceps that extend the elbow

(ABU-HIJLEH, 2019)
(MELLICK, 2010)
 • Inspection of the overlying soft tissues
• If the fracture is open, a clinical photograph may be
PHYSICAL taken for documentation purposes
• Perform a neurovascular examination. Radial nerve
EXAM FOR injury following humerus shaft fractures is relatively
common.
FRACTURES • Palpate the entire limb—including the joints above
and below the injury—for areas of pain, effusions,
and crepitus.

(BUCKLEY, 2018)
 • Proximal
• Painful shoulder & restricted ROM
PHYSICAL • Obvious deformity suggests glenohumeral dislocation; presents
with swelling and ecchymosis
EXAM FOR • Mid-shaft
BONE • Painful deformed arm that may be associated with a reversible
radial nerve palsy

FRACTURES • Crepitus may be observed

• With all humeral fractures, ensure strong radial and

ulnar pulses

(SRIVASTAVA, 2015)
IMAGING OF THE ARM BONE
Density Appearance
Air Absorbs the least X-Rays and
appears blackest
Fat Gray (darker than soft tissue)

Fluid or Soft Tissue Light Gray

Calcium Most dense

Metal Absorbs all the X-rays and

appears whitest

(HERRING, 2016)
REFERENCES
• Abu-Hijleh, M. (2019). Brachial Plexus.
• Buckley, R. (2018). General Principles of Fracture Care Clinical Presentation: History and Physical
Examination, Description and Classification, Complications. [online] Emedicine.medscape.com.
Available at: https://emedicine.medscape.com/article/1270717-clinical [Accessed 27 Feb. 2019].
• Herring, W. (2016). Learning radiology. Philadelphia, Pa.: Elsevier.
• Mellick, L. (2010). Radial Nerve Palsy. [video].
• Apma. (2019). Neuromas. [online] Available at:
https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=987 [Accessed 27 Feb. 2019].
• Srivastava, A. (2015). Humerus Fracture Clinical Presentation: History, Physical, Causes. [online]
Emedicine.medscape.com. Available at: https://emedicine.medscape.com/article/825488-
clinical#b4 [Accessed 27 Feb. 2019].
• WebMD. (2019). Symptoms of a Broken Bone. [online] Available at: https://www.webmd.com/a-
to-z-guides/understanding-fractures-symptoms [Accessed 27 Feb. 2019].