Musculoskeletal Trauma

Question 1

Common Sports Injuries

Answer 1

concussions

muscle cramps

ACL injuries

ankle sprains

shin splints

fractures

dislocations labral tears

stress fractures

tendinitis

cartilage damage

Question 2

What is strain?

Answer 2

tearing/pulling of muscle or tendon

can be the same as tendinitis

three levels of grading

Question 3

What is a sprain?

Answer 3

tearing or pulling of a ligament

Question 4

What is a dislocation?

Answer 4

when bone articulations pop out of place

the bigger the joint, the more urgent the reduction

usually debilitation and an emergency

loss of blood supply - risk for avascular necrosis

Question 5

How do you treat a knee dislocation?

Answer 5

closed reduction

splinting

neurovascular check

**risk of nerve and arterial damage

Question 6

What is a closed fracture vs. an open fracture?

Answer 6

in a closed fracture, the skin is intact

in an open fracture the skin is violated and there is a risk of infection and occult tissue damage

Question 7

What is reduction?

Answer 7

lining up a fracture/joint and putting it back in place

Question 8

What is closed reduction vs. open reduction?

Answer 8

closed reduction is simply pulling hard

open reduction is making an incision and exposing the bone

Question 9

What are the types of fixation?

Answer 9

none - let the body heal itself through a sling, brace, splint, or cast

external - exertnal fixation using an external device to ensure a bone doesn’t bend, if there are soft tissue injuries and unstable patients

internal fixation - stabilization by placing the device inside the tissue: plate/screw constructs, intramedullary nail/rod, plate/screw construct

Question 10

What is ORIF?

Answer 10

open reduction internal fixation - an operation inorthopedics that involves the surgical implementation ofimplants for the purpose of repairing abone

Question 11

What are the open fracture treatments?

Answer 11

irrigation, debridement, and fixation

Question 12

irrigation

Answer 12

diluting bacteria

Question 13

debridement

Answer 13

get rid of necrotic tissue

Question 14

Why are open fractures treated with irrigation, debridement, and fixation?

Answer 14

reduce infection risk

explore wound

debride necrotic tissue

Question 15

What is compartment syndrome?

Answer 15

limb and life threatening

increased pressure in an enclosed compartment (arm, leg, belly)

pressure not released -> ischemia -> permanent tissue damage

Question 16

What is the etiology of compartment syndrome?

Answer 16

injury -> inflammation/edema

fracture

vascular injury

crush

snake bite

burns

Question 17

What is the treatment for compartment syndrome?

Answer 17

fasciotomy - opening up an entire anatomic compartment and release the pressure

Question 18

What is the presentation of compartment syndrome?

Answer 18

pain out of proportion to injury, in compartment on passive stretching of toes or fingers

pallor

paralysis

pulselessness

parasthesias

compartment is rock-hard, tense, and swollen

**you’re too late if you see all 5

Question 19

What is the ischemial threshold of normal muscle?

Answer 19

20 mmHg below diastolic BP

30 mmHg below mean arterial pressure

Question 20

What is the result of missed compartment syndrome?

Answer 20

muscle death

permanent nerve damage

contractures

deformities

ulcerations

amputation

Question 21

What is a pathologic fracture?

Answer 21

fracture through abnormal bone

usually from metastatic disease

Question 22

What are the common locations for new metastatic bone disease?

Answer 22

breast

lungs

thyroid

kidney (renal)

prostate

Question 23

What is the MOST common distribution of metastatic bone disease?

Answer 23

spine is the MOST common