Flashcards in fractures Deck (66):
what type of fx is strait across?
what type of fx is diagonal?
what type of fx is in many pieces?
what type of fx is two transverse fx's?
what type of fx is rammed?
what is the other name for a buckle fx?
what is the term for when a 2 fx pieces are spread apart farther than normal anatomy?
what is the term for one fractured piece that is shifted out of it's anatomical plane?
what is the term for when a fractured piece is at a new angle?
what is the term for when a fractured piece has slid back over another?
What factors are prognostic indicators for good bone remodeling?
youth, proximity to the physis
what factors are poor prognostic indicators for less bone remodeling?
intra-articular, diaphyseal, malrotation
what is another term for the metaphysis?
salter harris I
salter harris II
salter harris III
salter harris IV
salter harris V
which salter harris is most likely to result in LLD, angular deformity, and significant LTD?
What is the weakest structure: ligaments, physes, or metaphyseal bone?
physes, especially in regards to torsional force
What fx's should be raising red flags for abuse?
posterior ribs, sternum, multiple stages of healing
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.
FOOSH'ing children =
torus fx, need to be casted minimally for 4 weeks
Fx proximal ulna, radial head dislocation
Fx distal radius, distal ulna dislocation
Peak incidence of scaphoid fx's occurs in pt's of what age?
late teens/early 20's
Tx of non-displaced scaphoid fx
tx of displaced scaphoid fx
what artery is at greatest risk during scaphoid fx?
tx of proximal humerus fx
nonoperatively in sling
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
how do you tx JOne's fx?
SLNWB x 6 weeks, then 4 wks, WB
who gets Jone's fx's
3 fx's of 5th metatarsal:
1) Most proximal--avulsion of styloid
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
imbalance b/t osteoclastic and osteoblastic activity causes:
what imaging is good for stress fx?
Xray, low threshold for MRI
What type of femoral neck fx's are stable?
What type of femoral neck fx's need fixation?
Fx of the _________ most commonly leads to acute compartment syndrome
tibia (leading to anterior comp syndrome)
5 P's of compartment syndrome
2) poikilothermia (cold)
When testing compartment pressure using a Striker monitor, what is the criteria for compartment syndrome?
Diastolic - opening pressure. Anything less than 30mmHg requires fasciotomy
When testing Neuro, an extended index finger proves intact fxn of the ________ nerve
A-Ok sign means the ____nerve is intact
digit abduction means the _______ nerve is ok
shoulder abduction means the _______ nerve is ok
dorsiflexion of foot means the ______ nerve is ok
plantar flexion of foot means the _______nerve is ok
contraction of the quads means the ________ nerve is ok
When are you at highest risk for fat emboli?
12-72 hours s/p fx of LONGBONE
What s/s are worrisome for fat emboli?
respiratory distress, CNS changes, petichiae
How do you treat fat emboli?
hypercoagulability, endothelial damage, and stasis are a recipe for _________
Virchow's triad: DVT
healing of fx in non-anatomic position:
wrist drop = ______nerve
What injuries are best tx'ed with a hard soled shoe?
toe fx, metatarsal fx
what injuries are best tx'ed with a WB?
WB protects foot and ankle: Ankle sprain, foot fx, some metatarsal fx's
when do you use a long arm splint?
elbow injury, distal humerus fx, FA fx
when do you use a sugartong?
when do you use a short leg posterior splint?
ankle fx/dislocation, distal tib fx
How long is the onset of pressure necrosis from a cast that is too tight?
What can be done about a cast that is too tight and risks compartment syndrome/pressure necrosis?
univalve = 30% pressure reduction
bivalve = 60% reduction
Casting padding should be applied from distal or proximal end?
distal to proximal....with 50% overlap, using 2 layers
If you have a displaced fx or dislocated joint, what is the big deal about reducing it?
MINIMIZE SOFT TISSUE COMPLICATIONS
What is the major principle of a closed reduction?
reversing the mechanism of injury to restore anatomy