Fracture Management: Lower Limb

Question 1

what is shenton’s line?

Answer 1

the curved line between the medial edge of the neck of the femur and the lateral edge of the superior pubic ramus

Question 2

what fracture does a blurry shenton’s line indicate?

Answer 2

neck of the femur fracture

Question 3

a proximal femur fracture is a fracture of what part of the body?

Answer 3

the hip

Question 4

what does intracapsular mean?

Answer 4

a fracture of a bone that is enveloped by the hip joint capsule

Question 5

what does an extracapsular fracture mean?

Answer 5

a fracture of bone below the hip joint capsule

Question 6

are neck of the femur fractures an extra or intracapsular fracture?

Answer 6

intracapsular

Question 7

name 3 types of fracture than can occur in the hip?

Answer 7

subcapital
intertrochanteric
subtrochanteric

Question 8

management of a subcapital hip fracture for young and old patients?

Answer 8

THR- young

hemiarthroplasty- old

Question 9

which of these fractures is extracapsular and which are intracapsular:
subtrochanteric
subcapital
intertrochanteric

Answer 9

extra
intra
extra

Question 10

management of an intertrochanteric hip fracture?

Answer 10

internal fixation or dynamic hip screw

Question 11

management of a subtrochanteric hip fracture?

Answer 11

internal fixation or dynamic hip screw

Question 12

which kind of hip fracture needs stabilised with a thomas splint before any surgery?

Answer 12

subtrochanteric

Question 13

what 2 sites of the thigh area can be fractured?

Answer 13

distal femur

femoral shaft

Question 14

2 kinds of distal femur fracture?

Answer 14

intraarticular - involving knee

extraarticular - not involving knee

Question 15

management of an extra-articular distal femur fracture?

Answer 15

IM nail if higher up

plating if distal

Question 16

management of an intra-articular distal femur fracture?

Answer 16

anatomical reduction with rigid fixation/plate and screws

Question 17

management of a stable femoral shaft fracture?

Answer 17

analgesia if femoral nerve blocked

thomas splint

Question 18

management of an unstable femoral shaft frature?

Answer 18

IM nailing

Question 19

most common cause of a distal femur fracture?

Answer 19

fall onto flexed knee and have osteoporosis

Question 20

complications of a femoral shaft fracture?

Answer 20

ARDS

fat embolism

Question 21

most common cause of a femoral shaft fracture?

Answer 21

high energy

Question 22

what 3 areas of the tibia can be prone to fracture?

Answer 22

proximal tibia
tibial shaft
distal tibia

Question 23

what 2 kinds of fracture can occur in a proximal tibial fracture?

Answer 23

intraarticular- involving knee

extraarticular- not involving knee

Question 24

what 2 kinds of fracture can occur in a distal tibial fracture?

Answer 24

intraarticular- involving ankle

extraarticular- not involving ankle

Question 25

cause of a proximal tibial fracture?

Answer 25

VALGUS stress i.e from high energy or osteoporosis

Question 26

what anatomical condition can occur after a proximal tibial fracture?

Answer 26

foot drop due to fibular nerve injury

Question 27

management of any proximal tibial fracture?

Answer 27

if high energy do high temp external fixation | if not do anatomical reduction and rigid fixation

Question 28

what percentage of displacement and degree of angulation would qualify for a knee cast in a tibial shaft fracture?

Answer 28

<50% displacement | <5 degrees angulation

Question 29

how would you manage a comminuted tibial shaft fracture?

Answer 29

IM nailing with plastics assistance | external fixation

Question 30

commonest cause of compartment syndrome after trauma?

Answer 30

a tibial shaft fracture

Question 31

how long does healing of a tibial shaft fracture take?

Answer 31

16 weeks

Question 32

how would you manage a stable extraarticular distal tibial fracture?

Answer 32

conservatively

Question 33

how would you manage an extraarticular distal tibial fracture that is very low down in the bone?

Answer 33

plate

Question 34

how would you manage an extraarticular distal tibial fracture that isn't too low down in the bone?

Answer 34

IM nailing

Question 35

what is the most serious of all kinds of tibial fracture?

Answer 35

intraarticular distal tibial fracture

Question 36

management of an intraarticular distal tibial fracture?

Answer 36

early ORIF or bridging external fixation if soft tissue not ok THEN bone graft

Question 37

another word for an intraarticular distal tibial fracture?

Answer 37

pilon fracture

Question 38

name the two areas of the ankle that can be fractured

Answer 38

distal tibia | distal fibula

Question 39

what would make a distal fibular ankle fracture unstable?

Answer 39

if the deltoid ligament was ruptured

Question 40

management of a stable distal fibular/tibial fracture

Answer 40

walking cast or splint for 6 weeks | conservative

Question 41

how would you manage an unstable distal fibular fracture?

Answer 41

ORIF with plates and screws

Question 42

mnemonic for the salter harris classification?

Answer 42

``` S traight across = type 1 A bove = 2 L lower/below = 3 T wo/through = 4 E = 5 R = 6 ```

Question 43

what joint can be affected in a calcaneal fracture?

Answer 43

subtalar joint

Question 44

cause of a calcaneal fracture?

Answer 44

fall from height

Question 45

management of heel fractures?

Answer 45

ORIF

Question 46

management of a midfoot fracture?

Answer 46

closed or open reduction with screw fixation

Question 47

another word for a midfoot fracture?

Answer 47

lisfranc fracture

Question 48

management of a stable metatarsal fracture?

Answer 48

moonboot for 4-6 weeks

Question 49

what fracture is commonly referred to as the "dancer's fracture"

Answer 49

fracture of the base of MT 5

Question 50

management of a proximal metatarsal fracture?

Answer 50

fixation | bone grafting + fixation if bad

Question 51

common metatarsal for a stress fracture?

Answer 51

2

Question 52

how should you manage an open fracture of a toe?

Answer 52

debridement and stabilisation with wires