for CBD qs Flashcards
(37 cards)
describe XR
details - date and time, area of body, adequacy ( 2 projections , joint above and below any rotation or penetration
alignment and joint space
bone texture -density
corticies
soft tissue
what type of fracture
where is it - diphysis, meta or epi
is it displaced
is something else going on like another fracture
what is closed fracture
- bone is broken but skin intact
open frcture
skin may be pierced, bone may be visible.
horizontal fracture
horizontal line fracture pressure from both up and down
spiral fracture
twisting motion of breaking - fracture line wraps around bone like a corkscrew
comminuted fracture
bone shatters in 3 or more places
impacted fracture
children due to bone compression - weight crumble or compression like jumping to pressure from below
greenstick fracture
partial thickness fracture where only cortex and periosteum are interrupted on one of the bone but remain interrupted on the other
incomplete fracture bowing
the long bone has been bent
buckle fracture
the fracture of the concave surface – (buckle fractures are also called torus and are defined as a compression of the bony cortex on one side with the opposite cortex remaining intact but greenstick fracture is when the opposite cortex is not intact.
why is it imrotnat to determine opne or closed
risk of infection with open fractures
growth plate salter harris 1
striaght through
SH 2
above GP - up through metaphysis
SH3 lower
fracture throuhg growth plate and down through epi
SH 4
trasverse - through metasphyis and grouth plate epi
SH5
rammed - direct compression of the growth plate
tx of fractures
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Immobilise the injured area. .
Apply ice packs to limit swelling and help relieve pain.
cast immobilisationn
functional cast
traction to align
external fixation
open reduction
arhtroplasty
OA on XR
LOSS
loss of joint space
osteophytes
subaraticualr sclerosis - increased density of the bone along the joint line
subchondral cysts - fluid filled holes
RA on XR
SPADES
soft tissue swelling
peri-arituclar osteoporosis
absent osteophytes
deformity
erosions - late
sublaxation - late feature
tx of OA
Start with patient education about the condition and advice on lifestyle changes such as:
Weight loss if overweight to reduce the load on the joint
Physiotherapy to improve strength and function
Occupational therapy to support activities and function (e.g., special devices and adaptations to the home)
Orthotics to support activities and function (e.g., knee braces)
The use of analgesia involves a stepwise approach to control symptoms:
Oral paracetamol and topical NSAIDs
Add oral NSAIDs (consider co-prescribing a proton pump inhibitor, such as omeprazole, to protect the stomach)
Consider opiates such as codeine
Other:
Topical capsaicin (chilli pepper) cream may be helpful, where available.
Intra-articular steroid injections provide a temporary reduction in inflammation and improve symptoms.
Joint replacement can be used in severe cases. The hip and knee are the most commonly replaced joints.
ACL done in sports injury that has twistin motion - sx
loud crack,
pain, rapid swelling
what test for ACL
anterior draw test /lachmans
PCL - hgh energy trauma such as direct blow to prox tibia - hyperexteniosn - posterior draw test and knee pain
what is the gold for all ligmaent injuries in the knee
MRI
plan xray to exlcude if you like
MCL - leg forced into vlagus force outside of leg - laxity on valgus stress test
what is the tx for all ligmanet tears
RICE
intense physio
NSAID and exercise MCL within 6 weeks if grade 1
surgery