Exam 3 UE Ortho Emergencies Flashcards Preview

Q4 EM Surg > Exam 3 UE Ortho Emergencies > Flashcards

Flashcards in Exam 3 UE Ortho Emergencies Deck (37):
1

Ortho injury basic rules? (4)

Compare injured to non-injured
Assess neurovasc above and below
Assess joint above and below
Multiple views for all XRays

2

Clavicle Fxr C in what population?

U from what motion?

kids

fall onto outstretched hand

3

Clavicle Fxr of Proximal 1/3 from what?

Middle 1/3?

Distal 1/3?

Direct blow

Most C

Direct blow to top of shoulder

4

Clavicle Fxr diagnostics?

XRay
Note angle of deformity and placement of fxr

5

Clavicle Fxr tx?

Repeat XRay when?

U heals how?

Arm sling
Immobilizer
Figure 8 brace
Refer to ortho

Repeat XRay 1-2 wks

U heals w/ deformity but fxn is normal

6

Scapular Fxr C in what population?

C associated injuries?

Young men but still very rare fxr
Takes extreme force

1st rib fxr
Hemo/Pneumothorax

7

Scapular Fxr diagnostics?

Scapular Fxr in kids suspicious for?

XRay

Abuse

8

Scapular Fxr tx? (4)

Depends on type
U hospitalize to watch for pneumothorax
Refer to Ortho if Hemo
Ice, immob, analgesic

9

Proximal Humerus Fxr C in what population?

Old ladies

10

Proximal Humerus Fxr locations? (4)

Anatomic neck
Greater tuberosity
Lesser tuberosity
Surgical neck

11

Proximal Humerus Fxr presentation? (3)

Mod to severe soft tissue swelling
Ecchymosis
Tender to palp

12

Proximal Humerus Fxr tx?

Minimal displacement = ice, clam shell, sling
Refer to Ortho to preserve ROM

13

Humeral Shaft Fxr U a/w injury to what?

Radial nn

14

Humeral Shaft Fxr exam, important to document what?

Extension of wrist, thumb, fingers BEFORE manipulation

15

Humeral Shaft Fxr tx?

Ortho
Hanging cast
Sugar tong, Clamshell, Sling

16

Shoulder dislocation U where?

Result of?

Anterior

Abduction + external rotation

If posterior, U cause by seizure

17

Shoulder dislocation presentation? (3)

Pt hold arm at slight abduction w/ opp hand
Prominent acromion
Should looks "squared off"

18

Shoulder dislocation XRay views?

Always look for?

AP
Lateral
Y-View

Associated fxr of humeral tubers and glenoid

19

Shoulder dislocation tx? (5)

Immediate reduction
Counter traction
Post-reduction XRays
Sling
Refer to Ortho

20

Shoulder dislocation reduction steps? (4)

1) Pt supine w/ elbow @ 90°
2) Shoulder in 20° forward flex
3) Shoulder externally rotate until forearm in coronal plane
4) Arm internally rotates until forearm in adduction (across belly)

21

Supracondylar Fxr C in what population?

Result of what motion?

a/w injury to what? (3)

< 15 yo

Fall on outstretched hand (FOOSH) w/ elbow locked ->
causes posterior displacement of distal fragment of humerus

Brachial aa, Median nn, Tricep

22

Supracondylar Fxr exam must include assessment of what?

Motor/Sensory Fxn of:
Ulnar, Median, Radial nn

Distal pulses

23

Supracondylar Fxr w/ abrasions/lacerations require what?

Early surgery

24

Supracondylar Fxr XRay findings?

Always look for?

Fluid accumulation POSTERIOR to distal humerus pushes fat pad out = Sail Sign

Associated dislocations
Olecranon

25

Supracondylar Fxr tx?

Non-displaced?

Early Ortho for ROM preservation

Splint ok

26

Nursemaid Elbow C in what population?

Result of what motion?

2-6 yo

Pulling on arm or falling ->
Subluxation of radial head

27

Nursemaid Elbow presentation? (4)

Pt holds arm slight flex/pronation
Guards arm
No swelling, bruising or focal tender
P wrist/forearm pain

28

Nursemaid Elbow tx?

Full extension in supination ->
Hold wrist ->
Thumb over radial head ->
Arm into flexion

Should be using arm in 5-10 min

29

Forearm Fxrs result of what motion?

Uncommon forearm fxr?

FOOSH
Direct blow

Isolated Ulnar
(think direct blow/abuse)

30

Forearm Fxrs presentation?

Local tender
Little swelling/ecchy

31

Monteggia Fxr is?

Presentation?

Proximal 1/3 of ulna w/ disolcation of radial head
"M is More proximal"

Very painful
Short extremity
Radial head palpable in antecubital fossa

32

Galeazzi Fxr is?

Fxrd radius w/ distal radioulnar joint disruption at wrist

33

Colles' Fxr is?

U a/w what other fxr?

Wrist Fxr causing Dorsal deformity of Distal Radius (dinner fork)
Result of FOOH

Ulnar

34

Smiths' and Barton Fxrs are?

Wrist fxrs causing Volar (palm) deformity of Distal Radius
Result of falling on back of hand

35

Wrist Fxr tx?

Ortho
Non-displaced = Sugar tong or volar splint
Displaced = open/closed reduction
Immob 6-8 wks

36

Scaphoid Fxr caused by what motion?

Presentation? (4)

(aka Navicular)
FOOSH

Anatomic snuff tender, esp w/ ulnar deviation
Min/No swelling/bruising
+/- painful thumb ROM
FREQUENTLY not visible on XRay

37

Scaphoid Fxr tx?

+ hx w/ tenderness = long arm thumb splint
Ortho to prevent avascular necrosis