Sports and orthopaedic emergencies Flashcards

1
Q

What should be the approach to an injured athlete ?

A

First Priority: -‐ Immediate threat to life
Second Priority: -‐ Urgent Injury which are potential threat to life
Third Priorty: -‐ Most common mild injuries, cuts and bruises.

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2
Q

What should be the Approach to the unconscious player/ Suspected C-‐spine injury?

A
  • MILS
  • ABCD
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3
Q

What is the indication for MILS ?

A

Cervical spine protection is indicated in the following trauma settings:
(i) Neck pain or neurological symptoms
(ii) Altered level of consciousness
(iii) Significant blunt injury above the level of the clavicles

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4
Q

What is the clinical presentation of mild TBI or concussion ?

A

Rapid onset of transient neurologic impairment that
Resolves spontaneously.
Acute clinical symptoms seen largely reflect a functional disturbance
rather than structural injury.

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5
Q

What is the clinical presentation of mTBI or concussion ?

A
  • Vacant stare
    *Attention deficit.
  • Delayed verbal expression and slurred speech.
  • Incoordination
  • Transient memory and conciseness deficit.
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6
Q

what should be the on-field management of C-Spine injury ?

A
  • MILS & ABCD
  • Do not move the player unless necessary/appropriate support
    present
  • Transfer to Hospital with full spinal immobilisation
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7
Q

What should be the management of acromio-clavicular disruption ?

A

Remove from play and Broad Arm Sling.

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8
Q

What are the static stabilisers of shoulder joint ?

A
  • Glenoid labrum
  • Glenohumeral ligaments
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9
Q

What are the dynamic stabilisers of shoulder joint ?

A
  • Rotator cuff muscles
  • long head of the Biceps brachialis.
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10
Q

what are the most common types of shoulder dislocations ?

A

95% anterior dislocation and 5% posterior dislocation.

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11
Q

What are the clinical signs of shoulder dislocation ?

A
  • Abducted & externally rotated arm position
  • Squaring of shoulder
  • Axillary nerve injury: Loss of sensation over
    regimental badge area
  • +/- Positive rotator cuff provocative tests
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12
Q

What is the management of shoulder dislocation ?

A

*Non-operative management is for acute dislocation consist of closed reduction and sling.
* For recurrent dislocations management through Bankart repair for stability.

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13
Q

What are the signs of ACL injury ?

A
  • Effusion
  • Quadriceps avoidance gait
  • Positive Lachman/Anterior Drawer Test
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14
Q

What is the pattern of traumatic force in pelvic injury ?

A

– AP compression 60-70%
– Lateral compression 15-20%
– Vertical shear 5-15%
– Complex (or combination) pattern

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15
Q

What should be the approach to crush syndromes ?

A

It is Usually seen in patients trapped for long time periods. ICU management under nephrology care is essential. Check renal function and creatinine kinase for rhabdomyolysis and related kidney injury.

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16
Q

What is the Jefferson fracture of C1?

A

A typical mechanism of injury is diving headfirst into shallow water. Axial loading along the axis of the cervical spine results in the occipital condyles being driven into the lateral masses of C1. The Jefferson fracture is not normally associated with neurological deficit although spinal cord injury may occur if there is a retropulsed fragment affecting the cervical cord. However, if posterior arch is involved it has significant risk of spinal compression.

17
Q

What is Hangman’s fracture of C2 pedicle ?

A

A Hangman’s fracture is a bilateral fracture traversing the pars interarticularis of C2) with an associated traumatic subluxation of C2 on the C3. It is the second most common fracture of the C2 vertebrae following a fracture of the odontoid process.

18
Q

What are the three types of Odontoid fractures ?

A

Type I- involves the apex of the dens and is mostly stable.
Type II- involves the neck of the odontoid process. They are categorized depending on the pattern of the fracture line into anterior oblique, posterior oblique, and horizontal variants.
Type III- fracture extends into the body of C2