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Ortho-Rheum > Orthopedic Trauma Day 1 > Flashcards

Orthopedic Trauma Day 1 Flashcards

1
Q

what does an open fracture require?

A

emergent orthopaedic care for surgical I&D and reduction

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2
Q

what is the treatment for an open fracture? (4)

A

irrigation at bedside with NS
wound dressing
IV antibiotics
tetanus

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3
Q

most shoulder dislocations (>90%) are classified as _____

A

anterior

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4
Q

shoulder dislocation puts what nerve at risk?

A

axillary nerve

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5
Q

what should always be done before and after a reduction?

A

neurovascular exam

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6
Q

what is the key to any reduction? (2)

A

relaxation
muscle fatigue

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7
Q

what is the treatment for shoulder dislocation? (2)

A

sling
gentle, progressive ROM exercises

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8
Q

what is the most common physical finding of a posterior shoulder dislocation?

A

shoulder locked in internal rotation

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9
Q

what must you get after any reduction?

A

xray

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10
Q

axillary view; is this an anterior or posterior dislocation?

A

anterior

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11
Q

axillary view; is this an anterior or posterior dislocation?

A

anterior

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12
Q

an injury of the anterior (inferior) glenoid labrum of the shoulder

A

bankart lesion

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13
Q

when does a bankart lesion occur?

A

when glenoid labrum is disrupted with shoulder dislocation

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14
Q

what is the treatment for bankart lesion?

A

surgery

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15
Q

a bankart lesion is often accompanied by a _____ _____

A

Hill-Sachs lesion

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16
Q

what is the arrow pointing at?

A

Bankart lesion

17
Q

cortical depression in the posterolateral head of the humerus that results from forceful impaction of the humeral head against the glenoid rim when the shoulder is dislocated anteriorly

A

Hill-Sachs lesion

18
Q

identify

A

Hill-Sachs lesion

19
Q

how can most clavicle fractures be treated?

A

sling

20
Q

which portion of the clavicle is most frequently injured?

A

middle

21
Q

which 2 muscles assist in dislocation of the clavicle?

A

pectoralis going down
sternocleidomastoid going up

22
Q

what should we check for on physical exam if a patient has a possible clavicle injury? (2)
to rule out what?

A

skin tenting + NV exam
to rule out brachial plexus injury

23
Q

what imaging should we do for a fracture of the proximal clavicle? what joint should we examine?

A

CT scan
sternoclavicular joint

24
Q

what is the treatment for a fracture of the proximal clavicle?

A

non-op

25
Q

what is an absolute surgical indication for a fracture of the middle clavicle? (2)

A

open injury
impending open “skin tenting”

26
Q

what are 5 relative surgical indications for a fracture of the middle clavicle?

A

> 2cm displaced
comminution
neuro compromise
nonunion with pain/limited ROM x 4 weeks
cosmetic/patient discomfort

27
Q

identify

A

fracture of the middle clavicle

28
Q

fracture of which part of the clavicle is most likely to nonunion?

A

distal clavicle

29
Q

what is the most common treatment for fracture of the distal clavicle?

A

mostly non-op but controversial

30
Q

displaced or non-displaced?

A

non-displaced

31
Q

displaced or non-displaced?

A

displaced

32
Q

a proximal humerus fracture is most common in which patients?

A

elderly with osteoporosis

33
Q

injury to which nerve is most commonly associated with proximal humerus fracture?

A

axillary nerve

34
Q

what is the most common treatment for proximal humerus fracture? (2)

A

non-op (sling and preserve ROM)

35
Q

what does treatment for a proximal humerus fracture depend on? (7)

A

age
fracture type
fracture displacement
bone quality
dominance
general medical condition
concurrent injuries

36
Q

a 72 yo patient presents with this. Dx? displaced vs non-displaced?
operative vs non-operative?

A

proximal humerus fracture
displaced
non-operative d/t age

37
Q

what can we offer if a patient wants a surgical option for a proximal humerus fracture?

A

shoulder replacement

38
Q

24 yo patient presents with this. Dx? operative vs nonoperative?

A

proximal humerus fracture w/ severe comminution
operative

Ortho-Rheum (27 decks)

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