fractures

Question 1

what type of fx is strait across?

Answer 1

transverse

Question 2

what type of fx is diagonal?

Answer 2

oblique

Question 3

what type of fx is in many pieces?

Answer 3

comminuted

Question 4

what type of fx is two transverse fx’s?

Answer 4

segmental

Question 5

what type of fx is rammed?

Answer 5

impacted

Question 6

what is the other name for a buckle fx?

Answer 6

torus

Question 7

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

Answer 7

distracted

Question 8

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

Answer 8

displaced

Question 9

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

Answer 9

angulated

Question 10

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

Answer 10

shortening

Question 11

What factors are prognostic indicators for good bone remodeling?

Answer 11

youth, proximity to the physis

Question 12

what factors are poor prognostic indicators for less bone remodeling?

Answer 12

intra-articular, diaphyseal, malrotation

Question 13

what is another term for the metaphysis?

Answer 13

“flare”

Question 14

salter harris I

Answer 14

physis

Question 15

salter harris II

Answer 15

metaphysis

Question 16

salter harris III

Answer 16

epiphysis

Question 17

salter harris IV

Answer 17

through both

Question 18

salter harris V

Answer 18

crush

Question 19

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

Answer 19

physeal

Question 20

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

Answer 20

physes, especially in regards to torsional force

Question 21

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

Answer 21

posterior ribs, sternum, multiple stages of healing

Question 22

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

Answer 22

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

Question 23

FOOSH’ing children =

Answer 23

torus fx, need to be casted minimally for 4 weeks

Question 24

Monteggia Fx:

Answer 24

Fx proximal ulna, radial head dislocation

Question 25

Galeazzi Fx:

Answer 25

Fx distal radius, distal ulna dislocation

Question 26

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

Answer 26

late teens/early 20's

Question 27

Tx of non-displaced scaphoid fx

Answer 27

thumb spica

Question 28

tx of displaced scaphoid fx

Answer 28

screw fixation

Question 29

what artery is at greatest risk during scaphoid fx?

Answer 29

radial

Question 30

tx of proximal humerus fx

Answer 30

nonoperatively in sling

Question 31

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

Answer 31

As though it is physis fx, young rarely have sprain

Question 32

how do you tx JOne's fx?

Answer 32

SLNWB x 6 weeks, then 4 wks, WB

Question 33

who gets Jone's fx's

Answer 33

teen athletes

Question 34

3 fx's of 5th metatarsal:

Answer 34

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

Question 35

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

Answer 35

ulnar gutter, 6 wks, <30 degrees

Question 36

imbalance b/t osteoclastic and osteoblastic activity causes:

Answer 36

stress fx

Question 37

what imaging is good for stress fx?

Answer 37

Xray, low threshold for MRI

Question 38

What type of femoral neck fx's are stable?

Answer 38

compression

Question 39

What type of femoral neck fx's need fixation?

Answer 39

tension

Question 40

Fx of the _________ most commonly leads to acute compartment syndrome

Answer 40

tibia (leading to anterior comp syndrome)

Question 41

5 P's of compartment syndrome

Answer 41

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

Question 42

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

Answer 42

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

Question 43

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

Answer 43

radial

Question 44

A-Ok sign means the ____nerve is intact

Answer 44

median

Question 45

digit abduction means the _______ nerve is ok

Answer 45

ulnar

Question 46

shoulder abduction means the _______ nerve is ok

Answer 46

axillary

Question 47

dorsiflexion of foot means the ______ nerve is ok

Answer 47

peroneal

Question 48

plantar flexion of foot means the _______nerve is ok

Answer 48

gastroc

Question 49

contraction of the quads means the ________ nerve is ok

Answer 49

femoral

Question 50

When are you at highest risk for fat emboli?

Answer 50

12-72 hours s/p fx of LONGBONE

Question 51

What s/s are worrisome for fat emboli?

Answer 51

respiratory distress, CNS changes, petichiae

Question 52

How do you treat fat emboli?

Answer 52

support, corticosteroids

Question 53

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

Answer 53

Virchow's triad: DVT

Question 54

healing of fx in non-anatomic position:

Answer 54

malunion

Question 55

wrist drop = ______nerve

Answer 55

radial

Question 56

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

Answer 56

toe fx, metatarsal fx

Question 57

what injuries are best tx'ed with a WB?

Answer 57

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

Question 58

when do you use a long arm splint?

Answer 58

elbow injury, distal humerus fx, FA fx

Question 59

when do you use a sugartong?

Answer 59

prevent pronation/supination

Question 60

when do you use a short leg posterior splint?

Answer 60

ankle fx/dislocation, distal tib fx

Question 61

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

Answer 61

2 hours

Question 62

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

Answer 62

univalve = 30% pressure reduction bivalve = 60% reduction

Question 63

Casting padding should be applied from distal or proximal end?

Answer 63

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

Question 64

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

Answer 64

MINIMIZE SOFT TISSUE COMPLICATIONS

Question 65

What is the major principle of a closed reduction?

Answer 65

reversing the mechanism of injury to restore anatomy

Question 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.

Answer 66

Volkmann's Contracture/vascular injury