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Fractures Flashcards

1
Q

Displacement

A

Translation of the distal fragment

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2
Q

Description of displacement in the hand

A

Volar

Dorsal

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3
Q

Angulation

A

Bone is at an improper angle

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4
Q

Medial angulation

A

Varus

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5
Q

Lateral angulation

A

Valgus

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6
Q

Carpal bones
Proximal
(Ulnar > Radial)

A

Triquetrium
Pisiform
Lunate
Scaphoid

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7
Q

Carpal bones
Distal
(Ulnar > Radial)

A

Hamate
Capitate
Trapezoid
Trapezium

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8
Q

Management of displaced and angulated fracture

A

Reduction under anaesthesia

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9
Q

Management of unstable extra-articular diaphyseal fracture

A

Fixed with open reduction and internal fixation

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10
Q

Management of displaced intra-articular fractures

A

Fixed with open reduction and internal fixation

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11
Q

Vessels prone to injury in pelvic fracture

A

Internal iliac

Pre-sacral venous plexus

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12
Q

Lateral compression fracture of the pelvis

A

Fractures through the pubic rami/ischium

SI joint disruption

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13
Q

Vertical shear fracture

A

Occurs due to axial force on one hemipelvis

Hemiplevis displaced superiorly

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14
Q

Open Book Pelvis Fracture

A

Anteroposterior compression injury

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15
Q

Which way does the surgical neck of the humerus displace in fracture?
Why?

A

Medial displacement of shaft

Due to pectoralis major

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16
Q

Mx of minimally displaced humeral fractures

A

Conservatively

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17
Q

Mx of displaced humeral fractures

A

Usually settle once muscle spasm stops

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18
Q

Mx of persistently displaced fractures

A

Usually internal fixation

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19
Q

Clinical Features of Anterior Shoulder Dislocation

A

Arm held adducted
Loss of symmetry
Axillary nerve injury (regimental badge patch)

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20
Q

Management of Anterior Shoulder Dislocation

A

Closed reduction under sedation/anaesthesia

Placed in a sling for 2-3 weeks then physiotherapy

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21
Q

Posterior Shoudler Dislocation

  • Classic sign
  • Mechanism
A

Light bulb sign on x- ray

Mechanism: posterior force on adducted internally rotated arm

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22
Q

Sign of anterior shoulder dislocation

A

Detachment of anterior glenoid labrum = Bankart lesion

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23
Q

Types of injury to the acriomioclavicular joint

A

Sprain
Subluxed
Dislocated

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24
Q

Subluxation of AC joint

A

Acriomioclavicular ligaments are usually ruptured

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25
Dislocated AC joint
AC ligaments and coracoclavicular ligaments also disrupted
26
Mx of AC joint injuries
Wear a sling for a few weeks
27
Mechanism of transverse and comminuted humeral shaft fractures
Direct trauma
28
Mechanism of oblique and spiral fractures
Fall +/- twisting injury
29
Angulation acceptable in humeral shaft fractures
30 o | Shoulder and elbow joint allow for this
30
Complication of humeral shaft fracture
Radial nerve Injury
31
Presentation of radial nerve injury
Wrist drop | LOS in the 1st web space
32
Management of humeral shaft fracture
IM nail
33
Mx of distal intra-articular humerus fracture
Open reduction and internal fixation
34
Olecranon Fracture | =
Fracture of the olecranon process of the ulna
35
Mechanism of olecranon fracture
Fall onto the elbow WITH Contraction of the triceps
36
Mx of Olecranon fracture
ORIF | If transverse, fix with wiring
37
Mechanism of radial head and neck fractures
FOOSH
38
Signs of undisplaced radial fracture
Fat pad on lateral x-ray
39
What does a fat pad suggest?
of 1+ bones at the elbow
40
Presentation of undisplaced radial head fracture
Lateral pain on supination/pronation
41
Mx of minimally displaced and undisplaced radial head fractures
Conservatively - sling
42
Mx of displaced radial head fractures
May require surgery | - IF fragments prevent full extension
43
Which way does the elbow dislocate? | Mechanism?
Posterior | Mechanism: FOOSH
44
Mx of uncomplicated elbow fracture
Closed reduction | Short period in sling
45
Nightstick Fracture
= fracture of the ulnar shaft
46
Mx of Nightstick Fracture
Conservatively | ORIF may improve return to function
47
Mx of diaphyseal fracture of both bones in the forearm
ORIF
48
Mx of minimally angulated fractures of both bones in the forearm - Children
Plaster cast | - The bones remodel
49
Mx of substantially angulated fractures of both arms in the forearm
MUA
50
Monteggia Fracture Dislocation | Definition
MURD Fracture of Ulna Radial Head Dislocation
51
Where does dislocation occur in Monteggia F-D?
Proximal head of the radius
52
Management of Monteggia F-D
ORIF of the fracture
53
Galeazzi Fracture Dislocation | Definition
GRUD Fracture of the radius Ulnar head Dislocation
54
Where does the dislocation occur in Galeazzi F-D?
Distal radioulnar joint
55
Investigation of Monteggi F-D
Forearm and elbow x-ray
56
Investigation of Galeazzi F-D
forearm and lateral wrist x-ray
57
Colles Fracture
= extra-articular fracture Distal radius Dorsal displacement
58
Which way does the fracture displace in Colle's?
Dorsally
59
Complications of Colle's fracture
Median nerve compression
60
Mx of minimally displaced Colle's fracture
Splint only
61
Smith's Fracture
= extra-articular fracture Distal radius Volar displacement
62
Mx of Smith's Fracture
ORIF with plates and screws
63
Complications of Smith's Fracture
Malunion
64
Which way does a Smith's fracture displace?
Volar
65
Barton's Fracture
= intra-articular Distal radius Dislocation of the radiocarpal joint
66
Classification of Barton's Fracture
Volar | Dorsal
67
Mx of Barton's Fracture
ORIF
68
Mx of comminuted intra-articular distal radius fracture
External fixation
69
Scaphoid fracture - Mechanism - Presentation
Mechanism: FOOSH | Tenderness in the anatomical snuffbox, pain compressing thumb metacarpal
70
Investigation of scaphoid fracture
4 x-ray views
71
Mx of scaphoid fracture
Plaster cast
72
Complications of scaphoid fractures
Non-union | Avascular necrosis
73
Perilunate dislocation - Definition - Mechanism
= dislocation of one of the carpal bones | Mechanism: hyperdorsiflexion
74
Mx of perilunate dislocation
Emergency | Closed reduction and pinning
75
Scaphoid Lunate Dissociation | - Sign
= scapho-lunate ligaments rupture | - See increased gap between scaphoid and lunate
76
Mx of scaphoid lunate dissociation
Closed reduction K wiring +/- ligament repair
77
Complications of femoral shaft fracture
Blood loss | Fat embolism
78
Management of femoral shaft fractures
Resuscitation Closed reduction Stabilisation
79
Distal femoral fracture | - Mechanism
Fall onto flexed position
80
Position of distal fragment in distal femoral fracture | - Mechanism
Flexed position | Gastrocnemii pulls distal fragment into flexed position
81
Mx of knee dislocation
EMERGENCY - high risk of vascular injury Reduce urgently NV assessment
82
Which way does the patellar 'nearly' always dislocate?
Laterally
83
Presentation of patellar dislocation
Pain over the medial retinaculum (tendon in knee) | May have haemarthrosis
84
Mx of patellar dislocation
Temporary splintage
85
Proximal tibial fracture | - Valgus stress
Causes lateral plateau fracture
86
Direct blow in proximal tibial fracture | - Risk
Can cause proximal fibular fracture | Injury to the common fibular nerve
87
Proximal tibial fracture | - Varus stress
Causes medial plateau fracture
88
Mx of proximal tibial fracture
Fixation
89
Mx of tibial shift fracture | - When non-operative?
Up to 50% displacement | 5 o angulation
90
Mx of tibial shaft fracture | - Operative
Internal fixation | - If comminuted usually require surgery
91
Distal tibial fracture
= distal tibial extra-articular fracture | - In good position that can be treated conservatively
92
Mx of more distal distal tibial fracture
Plating
93
Mx of less distal distal tibial fracture
IM nail
94
Pilon fracture
= intraarticular fracture of distal tibia, needs ORIF
95
Why might an ankle fracture be unstable? | - Management
Rupture of the deltoid ligament | Mx: ORIF
96
Criteria for assessing ankle fracture
Ottawa
97
When to x-ray an ankle?
Severe localised bony tenderness OR Inability to weight bear 4 steps
98
Signs of deltoid ligament rupture on ankle x-ray
Talar shift on AP x-ray
99
Risk of calcaneal fracture
Compartment syndrome

Musculoskeletal (7 decks)

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