Clavicle
o Rest in sling or collar and cuff for two weeks
o Active shoulder movement started after first week
Femur - trochanteric region
o Fixation with dynamic hip screw
o Early postoperative mobilisation is important
Femur - shaft
o Operative reduction usually required
o Internal fixation achieved with intramedullary nail
Fibula - shaft
o Protect limb in below knee walking cast for 3 weeks
Humerus - neck
o In elderly disregard fracture and concentrate on shoulder
movement
o If fracture impacted begin mobilisation early
Humerus - supracondylar region
o Reduce by manipulation under anaesthesia
o Place in full length cast with elbow at 90 degrees
o Observe carefully distal circulation
Olecranon
o Undisplaced fractures need immobilisation in right angled arm
plaster
o Displaced and comminuted fractures require internal fixation
o Internal fixation can be achieved with tension band wires
Patella
o Undisplaced fractures should be protected in full leg cast for 3
weeks
o Displaced fractures require internal fixation with screw or
tension band wire
o Comminuted fractures may require patellectomy
Phalanges
o Undisplaced fractures should be strapped for 2-3 weeks
o Displaced fractures may require manipulation and external
fixation
Radius - head
o If minimal displacement place in collar and cuff for 3 weeks
o If severely comminuted excise radial head
Scaphoid
o Immobilise in Scaphoid cast until fracture united
Tibia - shaft
o Undisplaced fracture require immobilisation in full leg cast
o Displaced fractures may require internal fixation with
intramedullary nail
Eponymous fractures
Bennett's fracture
o Intra-articular fracture of the base of the first metacarpal
o Usually requires open reduction and internal screw fixation
Colle's fractures
Bibliography
Krasin E, Goldwirth M, Gold A, Goodwin D R. Review of the current
methods in the diagnosis and treatment of scaphoid fractures. Postgrad Med
J 2001; 77: 235-237.