Extremity trauma

Question 0

compression causes what type of fracture

Answer 0

oblique

Question 1

tension causes what type of fracture

Answer 1

Transverse fracture

Question 2

Rotation causes what type of fracture

Answer 2

Spiral fracture

Question 3

angulation causes what type of fracture

Answer 3

transerverse

Question 4

what causes a spiral fracture

Answer 4

torque and axial compression

Question 5

define Apposition

Answer 5

the closeness of the bony contact at the fracture site

Question 6

how do you discribe apposition

Answer 6

describe the offset of the distal in relation to the proximal

Question 7

define alignment

Answer 7

describes the position of the distal fragment in rlation to the proximal in the longitudinal axis

Question 8

define rotation

Answer 8

produced by a twisting force along the longitudinal axis

Question 9

what are falls on outstretched hand injuries commonly referred too as?

Answer 9

FOOSH injuries

Question 10

<5yrs old FOOSH injury

Answer 10

supracondylar fracture

Question 11

5-10yr FOOSH injury

Answer 11

transverse radial metaphysis fx

Question 12

10-16 yr FOOSH injury

Answer 12

epiphyseal separation radius

Question 13

16-35 yr FOOSH injury

Answer 13

scaphoid or other carpal fx

Question 14

> 40 yr FOOSH injury

Answer 14

Colles fx or ulna fx

Question 15

> 70 yr FOOSH injury

Answer 15

Surgical Neck of humerus fx

Question 16

what are the indirect signs of fx as diagnostic clues

Answer 16

Joint effusions
soft tissue swelling
double cortical line
buckling of the cortex
intracapsular fat-fluid level
periosteal or endosteal reactions
displacement or obliteration of fat stripe

Question 17

what is the rate of fracture repair in infants

Answer 17

rapids and complete in 4-6 weeks

Question 18

what is the rate of fracture repair in adolescents

Answer 18

less rapids and complete in 6-8weeks

Question 19

what is the rate of fracture repair in adults

Answer 19

union is slow 10-12 weeks or sometimes 16-20 weeks

Question 20

when is the first radiographic visualization of callus?

Answer 20

about 14 days

Question 21

what are the steps to bone healing

Answer 21

1) hematoma formation
2) fibrocartilaginous callus formation
3) bony callus formation
4) bone remodeling

Question 22

what is clinical union of a fx

Answer 22

when the callus is sufficiently developed to allow weight bearing or similar stress

Question 23

what factors influence the rate of repair

Answer 23

degree of local trauma
age of the patient
vascularity of the fragments
separation of the fragments
inadequate immobilization
presence of infection of other focal pathologies

Question 24

what are the complications of fractures

Answer 24

``` nonunion delayed union arrest of growth stimulation of growth malunion or angular deformities avascular necrosis of infection DJD ```

Question 25

complications AWAY from site of fracture

Answer 25

``` shock synovitis fat embolism sub periosteal ossification intra and periarticular adhesions reflex sympathetic dystrophy ```

Question 26

complications of soft tissue (with fractures)

Answer 26

injuries to nerves, blood vessels, tendons, Ligs, muscles bowel, bladder, lungs kidneys etc...

Question 27

what salter harris fx is though the physis and metaphysis

Answer 27

type 2

Question 28

what type of salter harris is through the physis and epiphysis

Answer 28

type 3

Question 29

what type of salter harris fracture is through the physis metaphysis and epiphysis

Answer 29

type 4

Question 30

what type of salter harris fx has normal radiographs until cessation of growth develops deformity?

Answer 30

type V

Question 31

what is the normal AC width

Answer 31

< 2-3 mm difference between sides

Question 32

what is the normal distance between coracoid and clavicle

Answer 32

11-13mm with <5mm bilateral difference

Question 33

what is the typical mechanism for injury of the AC joint

Answer 33

FOOSH or direct blow to top of the shoulder

Question 34

what is the most common location of clavicle fracture

Answer 34

middle third (80%)

Question 35

with a middle third clavicle fracture the proximal fragment is elevated by____ and the distal fragment is depressed by ____

Answer 35

elevated by the SCM and depressed by the weight of the shoulder

Question 36

complications of clavicle fx's

Answer 36

exuberant callus may cause neurovascular comprimise malunion or nonunion laceration of the subclavian artery or brachial plexus distal DJD

Question 37

what is a "Flap" fx

Answer 37

avulsion of the greater tuberosity of the humorous

Question 38

how much displacement indicates a rotator cuff disruption with a flap fx?

Answer 38

1cm

Question 39

what is the most common type of shoulder dislocation

Answer 39

anterior (97%)

Question 40

what are the three subcategories of ant. shoulder dislocation

Answer 40

subcorcoid subglenoid intrathoracic

Question 41

what are the mechanisms of ant. shoulder dislocation

Answer 41

forceful extension or abduction forcful elevation and external rotation direct blow foosh

Question 42

what creates the Hill sachs defect

Answer 42

impaction fracture of the humeral head and glenoid fossa

Question 43

what is a bankart lesion

Answer 43

avulsion of the inf. glenoid rim

Question 44

which type of shoulder dislocation is due to hyperabduction

Answer 44

inferior dislocation

Question 45

tennis racquet, light bulb sign trough sign rim sign are all indications of what?

Answer 45

post. shoulder dislocation (very rare and hard to see on x-ray)

Question 46

what does Luxatio erecta mean?

Answer 46

inf. dislocation

Question 47

what make up the rotator cuff?

Answer 47

supraspinatus infraspinatus teres minor subscapularis

Question 48

what is the gold standard for rotator cuff injuries

Answer 48

MRI

Question 49

what are the radiologic findings of a rotator cuff tear

Answer 49

acromiohumeral joint space less than 6mm erosion of inf. aspect of acromian process flattening of grater tuberosity

Question 50

what is the MC spot of a rotator cuff tear

Answer 50

supraspinatous (inf. outer edge of acromion)

Question 51

what is the Critical zone

Answer 51

an area of decreased vascular supply in the supraspinatus tendon where most tears occur and is about 1cm from insertion

Question 52

what is the MC elbow injury in children

Answer 52

supracondylar fx (60%)

Question 53

what is the MC elbow injury in adults

Answer 53

radial head or neck (50%)

Question 54

what are radiographic signs of elbow injury

Answer 54

positive fat pad sign radio- capitellar line ant. humeral line hockey stick appearance

Question 55

what is a chisel fracture

Answer 55

vertical radiolucancy in radial neck

Question 56

what is the Numonic for ossification centers of the elbow

Answer 56

C.R.I.T.O.E - (capitellum,radius,internal epicondyle,trochlea,olecranon,external epicondlye) 1.3.5.7.9.11 (YEARS)

Question 57

discribe nursemaids elbow

Answer 57

fx in toddlers 2-5yrs from sudden jerk on forearm while in pronation with normal radiographs causes entrapment of annular ligament by radial head

Question 58

what are the MC joint dislocations in adults in order

Answer 58

1) shoulder 2) interphalangeal joints of fingers 3) elbow

Question 59

what is the MC elbow dislocation

Answer 59

Post./posterolateral (90%)

Question 60

what is a minimally displaced oblique fracutre of the distal ulnar shaft

Answer 60

Nightstick fracture

Question 61

what view is a torus fx best seen

Answer 61

lateral view

Question 62

what is normal volar tilt range

Answer 62

10-15 degrees