5 Fractures Flashcards
(39 cards)
How to describe a fx to ortho?
- Soft tissue integrity
- closed vs open - Type
- comminuted, oblique, spiral, intra-articular - Location
- distal vs proximal
- metaphyseal, diaphyseal, physeal - Displacement
- nondisplaced, displaced, rotated, angualated - Fx length
- distracted, impacted, shortened
Medaphyseal
Diaphyseal
Physeal
Definitions
Metaphyseal - end
Diaphyseal - middle
Physeal - growth plate
—— (. ) epiphyseal ——. Physeal —— I. I metaphyseal I. I I. I diaphyseal
Two types of stress fracture?
Stress (fatigue)
- normal bone - subjected to repeated abuse
Stress (insufficiency)
- weakened bone - subjected to repeated abuse
Pathologic fracture?
Fx through bone weakend by tumor, metabolic bone disease or osteoporosis
Depression fx?
A type of impaction fracture that occurs in the knee when the femoral condyle strikes the softer tibial plateau
** impaction fx is bone striking bone
Bayonetted fx?
Distracted fragment longitudinally overlaps the proximal fragment (usually the femur)
Distracted fx?
Distal fragment is separated from the proximal fragment by a gap
Carpal bones?
She looks too pretty
try to catch her
(Radial - ulnar)
S - scaphoid L - lunate T - triquetrum P - pisiform T - trapezium T - trapezoid C - capitate H - hamate
When assessing for wrist fractures look at?
Ulnar - Ulnar cortex - Ulnar styloid Radius - Distal radial cortex - Radiocarpial joint Carpals - Trace the 3 carpal arcs - check the intercarpal joint spaces are equal
AP and Lat are the same checks except in Lat you should trace the scaphoid
Assess the distal radius for?
Articular step off - <2 mm Ulnar variance - +/- <3mm Volar tilt - 11* Radial height - 11 mm Radial inclination - 22*
Smith and colles fracture?
Smith - radial fx with volar dislocation
Collies - radial fx w dorsal dislocation
Slide 27
Chauffeur fracture
Scapholunate injury
- lateral tip of radius is fractured
Slide 29
Die-punch fracture
Die-punch fractures result from an axial loading force on the distal radius. It is an intra-articular fracture of the lunate fossa of the distal radius
- square in the middle of the radial ephysis
Ankle fx require what x-rays?
AP
Lat
Mortise
Distal fibula fx classification
Dannis-weber
A - fibular fracture distal to ankle mortise
- stable fx (cam walker)
B - fib fx is oblique, begins at level of mortise and extends proximally
- unstable (closed reduction and casting)
C - fibular fx is proximal to ankle mortise (high) and the syndesmosis is disrupted
- ORIF
With fibular fx make sure you check?
Syndesmotic disruption
- changes the fix
Bimalleolar injury?
Lateral and medial fx
Or
Distal fib fx w disruption of deltoid ligament
Trimalleolar inj
Malleolar fx of
- Medial
- Lateral
- Posterior
May see posterior dislocation
A ____ ____ is considered an elbow fx until proven otherwise
Sail sign (posterior fat pad)
Pediatric elbow features
CRMTOL
CRMTOL
C - capitellum (age 1) R - radial head (age 3) M - medial epicondyle (age 5) T - trochlea (age 7) O - olecranon (age 9) L - lateral epicondyle (age 11)
Slide 42 has pics
Physeal fx?
Saltr harris fx
```
S - straight
A - above
L - beLow
T - through
R - cRushed
I
—
.
~~~
Thurston holland?
It is the chunk of bone broken off in a SALTR II
Fracture healing generally requires?
Immobilization for healing
UE - 4-6 weeks
LE - 8+ weeks
Factors that increase fracture prognosis?
Factors that increase stability
- skeletal immaturity (more remodeling etc)
- nondisplaced fx
- single bone fx (radius/ulnar) (Tib/Fib)
- thoracic spine (ribs stabalize)
