091214 injury and healing Flashcards Preview

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Flashcards in 091214 injury and healing Deck (35):
1

most common mechanism for ankle sprain?

inversion

2

most commonly sprained ligament in the ankle

anterior talofibular ligament

3

why is inversion most common mechanism for ankle sprain?

because you have fibula obstructing the tibia from rolling outward (eversion)

also, you have deltoid complex--ligamentous stability on the medial aspect but on the lateral aspect, not so

4

ankle sprain, 1st treatment?

RICE (rest, ice, compression, elevation)

5

ankle sprain, 2nd treatment?

ibuprofen (for the inflam)

6

5th metatarsal fracture-jones fracture

traumatic fracture at metaphyseal-diaphysis junction

7

5th metatarsal fracture-pseudo jones fracture

stress fracture at proximal diaphysis

8

5th mettarsal fracture-dancer's fracture

spiral fracture mid to distal diaphysis

9

5th metatarsal fracture-avulsion fracture

5th metatarsal base at peroneus brevis insertion

10

how do you get avulsion fraction at the fifth metatarsal of foot?

the fibularis tertius tendon pulls at the base of the metatarsal and can get bone pulled off (b/c in a 9 yr old, would have weak growth plate)

11

Maisooneuve fracture

proximal fibula fracture

12

squeeze test

squeezing middle of leg--if positive squeeze test, means that you have pain the knee or ankle

if positive for the knee, you worry about a Maisonneuve fracture

if positive for the ankle, worry about a high ankle sprain

13

if you externally rotate (external rotation test) the ankle and you have a standard lateral ankle sprain, what would the symptoms be?

symptoms would stay the same

14

high ankle sprain

disruption of syndoesmosis btwn tibia and fibula or the transeverse tibiofibular ligament inferiorly

15

which kind of tissue heals with least complete recovery?

cartilage

16

rotator cuff tear

is a tendon tear

17

which of following would make you suspcious most for a loose body?

locking, swelling, pain, weakness or buckling?

locking

18

isolated medial collateral ligament tear-does it need surgery?

no, will heal pretty well on its own due to good blood supply

19

anterior talar fibular ligament sprain is a sprain of what degree

mild

20

ligament healing depends on

good blood supply
needs damage section to be approximated or guided to correct area

needs relative rest

a lot of ligament tears will therefore heal pretty well w/o surgery, but in the case of ACL (lack of good blood supply), will need to consider surgery

21

when does the repair stage of bony healing kick in?

1 to 2 more more weeks after, goes until 3 or more months

22

what to look for on radiograph with bony healing

is there sclerosis? appropriate healing?

23

bony healing remodeling goes from when?

1-2 years after the fracture

24

when do osteoclasts and osteoblasts invade the bloot clot after a bony fracture?

in the repair stage

25

what happens in the repair stage for bony healing?

osteoclasts and osteoblasts invade the blood clot
soft callus formation
hard callus
callus matures
bony gaps bridged

26

does time correlate with strength of healed bone?

generally yes, but not always (for ex, in the case of non union)

27

with a transverse fracture that is displaced with angulation, what surgical approach would you use

would pull the bones so they align and place in an intramedullary rod

28

Osgood Schlatter's

due to weakness of immature skeleton compared to mature skeleton; repetitive tugging at growth plate

see irregularity and fragmentation of the tibial tubercle, where the patellar tendon inserts

see soft tissue swelling

29

metaphysis

area btwn shaft and growth plate

30

damage to the growth plate can cause

growth disturbances

31

physis

growth plate

32

apophysitis

pain and inflam of ossification centers from repetitive tension

33

treatments for apophysitis

activity as tolerated, stretching, ice and NSAIDs

34

complications of apophysitis

if severe, can get bony hypertrophy
fracture is rare

35

common sites of apophysitis

osgood schlatter-tibial tubercle
sever's-calcaneal
sinding larsen johansson-distal patellar pole
anterior superior iliac spine-sartorius
anterior inferior iliac spine-rectus femoris
little leaguer's elbow0medial epicondyle