EMQs in Clinical Medicine.pdf - Peshawar Medical College

Fall on the outstretched hand 119
49 Fall on the outstretched hand
A
B
C
D
E
F
Colles’ fracture
scapular fracture
posterior dislocation shoulder
olecranon fracture
anterior dislocation shoulder
scaphoid fracture
G
H
I
J
K
L
Galeazzi’s fracture
fracture clavicle
Monteggia’s fracture
supracondylar fracture
fractured humeral shaft
Smith’s fracture
For each clinical scenario below, suggest the most likely injury that has resulted.
Each option may be used only once.
1 A 24-year-old woman presents with pain on wrist movements after a fall on to
her hand. On examination there is tenderness and swelling in the anatomical
snuffbox.
2 A 68-year-old woman presents with fracture at distal radial head with dorsal
displacement of distal fragment after a fall.
3 A 7-year-old boy presents with a swollen painful elbow after a fall. He is unable
to move the arm because of the pain.
4 A 19-year-old rugby player falls on a backward stretched hand and presents with
loss of shoulder contour and absent sensation on a patch below the shoulder.
5 A 40-year-old woman presents after a fall on an outstretched hand with
wrist drop.
Answers: see page 131.