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Flashcards in Fracture management Deck (76):
1

What mechanism of injury commonly causes humeral neck fractures?

Falling onto an outstretched hand with osteoporotic bone.

2

Most common humeral neck fracture?

Surgical neck fracture with medially displacement of the humeral shaft due to the pec major pull.

3

Minimally displaced proximal humeral fracture management?

Conservative- with sling and gradual return to mobilisation.

4

Persistently displaced humeral neck fractures?

Internal fixation (plate, screws, wires or IM nails)

5

Humeral head splitting fractures?

Replacement- arthroplasty.

6

What is more common, anterior or posterior shoulder dislocation?

Anterior

7

Mechanism of injury of traumatic anterior shoulder dislocation?

An excessive internal rotation force.

8

Bankurt lesion

Anterior shoulder dislocation resulting in detachment of the anterior glenoid labrum and capsule.

9

Hills-sachs lesion

Posterior humeral head can impact on the anterior glenoid producing an impaction fracture of the posterior head.

10

Nerve at risk in anterior shoulder dislocation

Axillary nerve

11

Sign of axillary nerve damage?

Loss of sensation in the badge patch area

12

What confirms an anterior shoulder dislocation?

Xray- if unsure use two views.

13

Management of anterior shoulder dislocation?

Closed reduction
Then use of sling for 2-3 weeks.

14

Anterior shoulder dislocation and greater tuberosity fracture?

Closed reduction then ORIF the fracture.

15

Mechanism of injury for a posterior shoulder dislocation

Posterior force on the adducted internally rotated arm.

16

Treatment of posterior shoulder dislocation

Closed reduction and sling.

17

How do acromioclavicular injuries usually occur?

Falling onto the point of the shoulder.

18

Treatment of acromioclavicular injuries?

Conservative management

19

Who gets surgery in acromioclavicular injuries?

Those with chronic pain.

20

Management of a humeral shaft fracture?

Conservative unless non-union.

21

Intra-articular distal humeral fractures?

ORIF

22

Olecranon fractures?

ORIF with plate and screws.

23

Mechanism of injury for olecranon fractures?

Fall onto the point of the elbow with contraction of the triceps muscle.

24

Radial head fractures- minimally displaced?

Conservatively.

25

Radial head fractures-comminuted?

ORIF if the fragment is large.

26

Fracture of the ulnar shaft is also known as

Nightstick fracture

27

Fracture of both bones in the forearm

ORIF

28

Monteggia or Galeazzi fracture?

ORIF

29

Colles fracture mechanism of injury?

Fall onto outstretched arm

30

Minimally displaced or angulated Colles fractures?

Splintage

31

Largely displaced Colles fracture?

ORIF with dorsal plate and screws

32

Smiths fracture management

ORIF using volar plate and screws.

33

Bartons fracture management

ORIF

34

Comminuted intra-articular distal radial fractures

External fixation

35

Scaphoid fracture mechanism of injury

Fall onto outstretched hand.

36

Undisplaced scaphoid fractures

Plaster cast for 6-12 weeks

37

Displaced scaphoid fractures

Screw fixation

38

3rd, 4th and 5th MCP fracture

Conservative

39

Boxers injury

Likely to damage 5th MCP
Up to 45 degrees of angulation can be tolerated- however rotational deformities can not.

40

Treatment of boxers injury

Strap to next finger.

41

Any suspicion of fight bite in boxers injury

Explore in theatre.

42

Management of phalangeal fractures

Neighbouring strapping or splint age

43

Significantly displaced phalangeal fractures

K wiring or small screws.

44

Intracapsular hip fractures

Hemiarthroplasty or total hip replacement

45

Extracapsular hip fractures

Dynamic hip screw

46

Subtrochanteric fracture

IM nail

47

Pubic rami fractures

Conservative

48

Greater trochanteric fractures

Conservative

49

Unstable femoral shaft fractures

IM nailing

50

Stable femoral shaft fractures

Thomas splint

51

Distal extra-articular femur fractures

Not too distal- IM nail
Distal- plate and screws

52

Distal intra-articular femur fractures

Plate and screws

53

Proximal tibial fractures

If high energy and substantial soft tissue damage may need external fixation
Rigid fixation

54

Intra-articular proximal tibial fractures

Plate and screws

55

Low energy tibial shaft fracture

Conservative

56

High energy tibial shaft fracture

IM nailing.

57

Distal tibial shaft fracture

May have too much soft tissue swelling- therefore need to externally fixate until safe to go in and put plate and screws.

58

Intra-articular fibula fracture also known as?

Pilon fracture

59

Significant soft tissue damage in intra-articular distal fibular fracture

Urgent external fixation
Internally fixate once soft tissues have settled.

60

Isolated distal fibular fracture?

Conservative

61

Bimalleolar fractures

ORIF

62

Fractures with talar shift

ORIF

63

Stable ankle fracture

Walking cast or splint age for 6 weeks.

64

Falling from height you are likely to fracture your?

Calcaneous

65

Talar fracture

ORIF

66

Lisfranc fracture

ORIF

67

5th MTP fracture

Walking cast, bandaging and stout boot

68

1st MTP fracture

ORIF

69

What might you use to view acetabulum fractures?

CT after Xray

70

Undisplaced or small acetabulum fractures?

Conservative

71

Unstable acetabulum fractures

ORIF in young
Older- hip replacement

72

Low energy pubic rami fracture in the elderly

Conservative

73

Lateral compression fracture description

Side impact where one half of the pelvis is displaced medially.

74

Vertical shear fracture description

Axial force on one hemipelvis where the affected side is displaced superiorly.

75

Anteroposterior compression injury description

Wide distribution of the pubic symphysis and the pelvis opens up. Substantial bleeding occurs.

76

Open book (anteroposterior compression) pelvic fractures management

Reduce to stop the blood loss. Maybe use an external fixation.