Lecture Summary

Elbow injuries are relatively less common in adults compared to wrist and shoulder. Fractures of the proximal radius are most common. While the fracture line may not be seen, almost always a fracture will demonstrate an elbow effusion on initial x-rays. It should be appreciated that fractures of the radial head (that enter the joint) are of greater clinical concern than fractures of the radial neck. For shoulder injuries, anterior dislocations are common. Posterior dislocations are far less common, and far more commonly missed with long-term consequences. For all patients with shoulder injuries, consider the diagnosis of a posterior shoulder dislocation before discharge (even for patients with a proximal humerus fracture). Doing so will minimize the miss rate.

Target Audience

Emergency Medicine Doctors
Emergency Medicine Nurses
Paramedics
Rural GP's

Learning Objectives:

Upon completion of this activity, you should be able to:

• Describe the most common adult elbow fracture and radiographic features of a proximal radial fracture that should increase clinical concern for the injury
• Compare and contrast anterior vs. posterior shoulder dislocations with regards to history, physical and x-ray findings
• Describe features of an adult mid-shaft clavicle fracture that predict healing complications

Upper Extremity Injuries: Hand and Wrist

A review

Emergency Medicine / Orthopaedics