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Flashcards in fractures Deck (66):
1

what type of fx is strait across?

transverse

2

what type of fx is diagonal?

oblique

3

what type of fx is in many pieces?

comminuted

4

what type of fx is two transverse fx's?

segmental

5

what type of fx is rammed?

impacted

6

what is the other name for a buckle fx?

torus

7

what is the term for when a 2 fx pieces are spread apart farther than normal anatomy?

distracted

8

what is the term for one fractured piece that is shifted out of it's anatomical plane?

displaced

9

what is the term for when a fractured piece is at a new angle?

angulated

10

what is the term for when a fractured piece has slid back over another?

shortening

11

What factors are prognostic indicators for good bone remodeling?

youth, proximity to the physis

12

what factors are poor prognostic indicators for less bone remodeling?

intra-articular, diaphyseal, malrotation

13

what is another term for the metaphysis?

"flare"

14

salter harris I

physis

15

salter harris II

metaphysis

16

salter harris III

epiphysis

17

salter harris IV

through both

18

salter harris V

crush

19

which salter harris is most likely to result in LLD, angular deformity, and significant LTD?

physeal

20

What is the weakest structure: ligaments, physes, or metaphyseal bone?

physes, especially in regards to torsional force

21

What fx's should be raising red flags for abuse?

posterior ribs, sternum, multiple stages of healing

22

You are concerned for elbow fx. What are you looking at on your lateral xray?

Check that the anterior line of humerus and mid radius create 90 degree angles in the middle of capitellum.

23

FOOSH'ing children =

torus fx, need to be casted minimally for 4 weeks

24

Monteggia Fx:

Fx proximal ulna, radial head dislocation

25

Galeazzi Fx:

Fx distal radius, distal ulna dislocation

26

Peak incidence of scaphoid fx's occurs in pt's of what age?

late teens/early 20's

27

Tx of non-displaced scaphoid fx

thumb spica

28

tx of displaced scaphoid fx

screw fixation

29

what artery is at greatest risk during scaphoid fx?

radial

30

tx of proximal humerus fx

nonoperatively in sling

31

Young patient thinks she sprained her ankle and is having ttp over lateral malleolus. Xray is normal. How do you treat?

As though it is physis fx, young rarely have sprain

32

how do you tx JOne's fx?

SLNWB x 6 weeks, then 4 wks, WB

33

who gets Jone's fx's

teen athletes

34

3 fx's of 5th metatarsal:

1) Most proximal--avulsion of styloid
2) Jone's
3) Stress

35

Boxer fx get's _____ cast x ____ weeks. Some angulation is ok, as long as it's less than ___ degrees

ulnar gutter, 6 wks, <30 degrees

36

imbalance b/t osteoclastic and osteoblastic activity causes:

stress fx

37

what imaging is good for stress fx?

Xray, low threshold for MRI

38

What type of femoral neck fx's are stable?

compression

39

What type of femoral neck fx's need fixation?

tension

40

Fx of the _________ most commonly leads to acute compartment syndrome

tibia (leading to anterior comp syndrome)

41

5 P's of compartment syndrome

1) pain
2) poikilothermia (cold)
3) pulselessness
4) pallow
5) paresthesia

42

When testing compartment pressure using a Striker monitor, what is the criteria for compartment syndrome?

Diastolic - opening pressure. Anything less than 30mmHg requires fasciotomy

43

When testing Neuro, an extended index finger proves intact fxn of the ________ nerve

radial

44

A-Ok sign means the ____nerve is intact

median

45

digit abduction means the _______ nerve is ok

ulnar

46

shoulder abduction means the _______ nerve is ok

axillary

47

dorsiflexion of foot means the ______ nerve is ok

peroneal

48

plantar flexion of foot means the _______nerve is ok

gastroc

49

contraction of the quads means the ________ nerve is ok

femoral

50

When are you at highest risk for fat emboli?

12-72 hours s/p fx of LONGBONE

51

What s/s are worrisome for fat emboli?

respiratory distress, CNS changes, petichiae

52

How do you treat fat emboli?

support, corticosteroids

53

hypercoagulability, endothelial damage, and stasis are a recipe for _________

Virchow's triad: DVT

54

healing of fx in non-anatomic position:

malunion

55

wrist drop = ______nerve

radial

56

What injuries are best tx'ed with a hard soled shoe?

toe fx, metatarsal fx

57

what injuries are best tx'ed with a WB?

WB protects foot and ankle: Ankle sprain, foot fx, some metatarsal fx's

58

when do you use a long arm splint?

elbow injury, distal humerus fx, FA fx

59

when do you use a sugartong?

prevent pronation/supination

60

when do you use a short leg posterior splint?

ankle fx/dislocation, distal tib fx

61

How long is the onset of pressure necrosis from a cast that is too tight?

2 hours

62

What can be done about a cast that is too tight and risks compartment syndrome/pressure necrosis?

univalve = 30% pressure reduction

bivalve = 60% reduction

63

Casting padding should be applied from distal or proximal end?

distal to proximal....with 50% overlap, using 2 layers

64

If you have a displaced fx or dislocated joint, what is the big deal about reducing it?

MINIMIZE SOFT TISSUE COMPLICATIONS

65

What is the major principle of a closed reduction?

reversing the mechanism of injury to restore anatomy

66

A permanent flexion of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers, caused by obstruction of the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome.

Volkmann's Contracture/vascular injury