Flashcards in 6- Adult Regional Trauma Deck (82)
When spinal shock occurs, loss of motor function and sensation occurs above the level of the injury. True/False?
BELOW the level of the injury
What normal body reflex is absent in spinal shock?
Describe complete spinal cord injury
No sensory or voluntary motor function below level of injury
Describe incomplete spinal cord injury
Some neurologic function present distal to level of injury
The presence of sacral spinal cord sparing in spinal cord injury indicates a better prognosis. True/False?
Pelvic fractures are more common in which age groups?
Young patients (high energy)
Old patients (osteoporosis)
Name the bones that form the pelvic ring
How is the pelvic ring like a polo mint?
If it breaks in one place, it will inevitably break in another part
What happens in lateral compression fracture of pelvis? Give an example
One half of pelvis is displaced medially
What happens in vertical shear fractures of the pelvis? Give an example
One half of pelvis is displaced superiorly
e.g. fall from height
What happens in anteroposterior compression injury of the pelvis? Give an example
Disruption of pubic symphysis (open-book-pelvis)
e.g. motorcycle accident
What neurovascular structures are at risk in pelvic fractures?
Branches of internal iliac artery
A PR exam is mandatory in pelvic fractures. True/False?
Assess sacral nerve root function, check blood
What is the most common mechanism of injury in proximal humerus fractures?
Low energy osteoporotic injury due to FOOSH
Which part of the proximal humerus is most commonly fractured?
In which direction does the humeral shaft usually displace in proximal humerus fractures?
Medially (due to pull of pectoralis major)
What is the mainstay treatment for proximal humerus fractures?
Internal fixation if recurrent displacement
Which direction of shoulder dislocation is most common?
What is a Bankart lesion?
Anterior shoulder dislocation causes detachment of glenoid labrum and capsule
What is a Hill-Sachs lesion?
Posterior humeral head impacts anterior glenoid, causing impaction fracture of posterior humeral head
Which nerve is at risk in shoulder dislocation?
Also other nerves of brachial plexus
What is the characteristic sign on XRAY in posterior shoulder dislocation?
What is the principle sign of axillary nerve injury?
Loss of sensation in badge-patch area
What is the mainstay of treatment for anterior shoulder dislocation?
Closed reduction under sedation/anaesthetic
Describe the relationship between risk of recurrent shoulder dislocation and age of the patient
Patients under 20yrs have 80% risk of re-dislocation; patients over 30yrs have 20% risk
What is involved in Bankart repair?
Reattach torn labrum and capsule via arthroscopy/open repair
How do injuries of the ACJ usually occur?
Fall onto the point of the shoulder
In subluxation of the ACJ, what is usually ruptured?
In dislocation of the ACJ, what is usually ruptured?