Presentation on theme: "Upper limb Lower limb. Lesions of the Brachial Plexus Fractures."— Presentation transcript:
Upper limb Lower limb
Lesions of the Brachial Plexus Fractures
5 Injury to C5-6 at Erb’s point Muscles paralysed – Deltoid, biceps, brachialis, barachioradialis Posture – waiter’s tip deformity Mechanism of injury : fall on shoulder or excessive pulling of head of new born during delivery Erb-Duchenne’s Palsy
7 Injury to C8-T1 Muscles paralyzed – small muscles of hand Deformity Claw hand Mechanism : Sudden superior pull on upper
Symptoms : Clawed hand due to loss of innervation of Intrinsic muscle of the hand
The characteristic clinical sign of radial nerve injury is wrist-drop.
A midhumeral fracture may injure the radial nerve in the radial groove in the humeral shaft. Fracture is not likely to paralyze the triceps because of the high origin of the nerves to two of its three heads.
SATURDAY NIGHT PALSY WRIST DROP Radial Nerve Injury in Axilla: Mechanism: 1.Crutches pressing in axilla 2.Saturday night palsy! Main Effect:
16 Carpal Tunnel syndrome Common in computer professionals. Due to constant dorsiflexion of wrist while typing the keyboard
Clavicle Humerus Radius Scaphoid
21 Junction of Medial 2/3 rd and Lateral 1/3rd
22 Fracture of Surgical Neck of Humerus Damage to Axillary nerve and Post. Circumflex humoral Artery Fracture of Mid Shaft Humerus Damage to Radial Nerve and Deep artery of Arm Fracture of Medial Epicondyle Damage to Ulnar Nerve Fracture of Supracondylar part: Damage to median nerve and Brachial artery
23 Overall : Dorsal Displacement of Wrist and Hand Specifically: Dorsal and Proximal Displacement of Distal segment of fractured radius Fall on Out stretched Hand This is more common in older person
Nerve lesions in lower limb Injuries of hip, knee and ankle joint
Injury to femoral nerve Injury to obturator nerve Injury to superior gluteal nerve Injury to inferior gluteal nerve Injury to sciatic nerve Injury to tibial nerve Injury to common fibular nerve Injury to deep fibular nerve Injury to superficial fibular nerve
Weakness of hip flexion Iliopsoas, rectus femoris, and sartorius Knee extension Quadriceps femoris Loss of sensation over anterior thigh and medial leg and foot
Loss of thigh abduction & medial rotation Gluteus medius, gluteus minimus, and tensor fasciae latae Positive Trendelenburg sign
Weakened hip extension Gluteus maximus Most noticeable when climbing stairs or standing from a seated position
Footdrop and loss of eversion May cause sensory loss over lateral leg and dorsum of foot Causes Direct trauma as nerve passes superficially around neck of fibula
Hip joint Knee joint Ankle joint
Posterior dislocation Posterior tearing of joint capsule Dislocated femoral head lies on posterior surface of ischium Occurs in head-on collision Damage to Ischiofemoral ligament Complications Sciatic nerve may damage.
Anterior drawer sign: This injury causes the free tibia to slide anteriorly under the fixed femur.
PCL ruptures allow the free tibia to slide posteriorly under the fixed femur.
The lateral ligament is injured because it is much weaker than the medial ligament. The anterior talofibular ligament part of the lateral ligament is most vulnerable and most commonly torn during ankle sprains.
During a football game, a player sustains a powerful blow to the lateral side of his weight-bearing leg. He experiences excruciating knee pain and is unable to walk. The three structures most likely to be injured are the Anterior cruciate and lateral collateral ligaments and the lateral meniscus Anterior cruciate and medial collateral ligaments and the medial meniscus Posterior cruciate and lateral collateral ligaments and the lateral meniscus Posterior cruciate and medial collateral ligaments and the lateral meniscus Posterior cruciate and medial collateral ligaments and medial meniscus