Upper limb
Lower limb
 Lesions
of the Brachial Plexus
 Fractures
Erb-Duchenne’s Palsy
 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
5
6
 Injury
to C8-T1
 Muscles paralyzed – small muscles of hand
 Deformity Claw hand
 Mechanism : Sudden superior pull on upper
7
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
Radial Nerve Injury in
Axilla:
Mechanism:
1.Crutches pressing in
axilla
2.Saturday night palsy!
Main Effect:
WRIST DROP
Carpal Tunnel
syndrome
Common in computer
professionals.
Due to constant
dorsiflexion of wrist while
typing the keyboard
16
18
 Clavicle
 Humerus
 Radius
 Scaphoid
Junction of Medial 2/3rd and Lateral 1/3rd
21
 Fracture
of
Surgical Neck of
Humerus
 Damage to
Axillary nerve
and Post.
Circumflex
humoral Artery
 Fracture
of
 Fracture of
Mid Shaft
Medial
Humerus
Epicondyle
 Damage to

Damage to
Radial Nerve
Ulnar Nerve
and Deep
artery of Arm
Fracture of Supracondylar part:
Damage to median nerve and Brachial artery
22
Fall on Out stretched Hand
Overall : Dorsal
Displacement of Wrist and
Hand
Specifically: Dorsal and
Proximal Displacement of
Distal segment of fractured
radius
This is more
common in
older person
23
24
 Nerve
lesions in lower limb
 Injuries of hip, knee and ankle joint
 Injury
 Injury
 Injury
 Injury
 Injury
 Injury
 Injury
 Injury
 Injury
to femoral nerve
to obturator nerve
to superior gluteal nerve
to inferior gluteal nerve
to sciatic nerve
to tibial nerve
to common fibular nerve
to deep fibular nerve
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
sign
Trendelenburg
 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.
 Unhappy
triad
 Anterior drawer sign
 Posterior drawer sign
 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



