Lecture 5 - Lower Limb Injuries Flashcards Preview

Block 2 - MSK > Lecture 5 - Lower Limb Injuries > Flashcards

Flashcards in Lecture 5 - Lower Limb Injuries Deck (27):
1

Hip dislocation

- axial load on flexed knee
- hip rests in flexion, adduction and internal rotation
- associated with acetabular rim fractures
- check for sciatic nerve injury

TREATMENT: reduction with traction at 90 degrees

2

Slipped capital femoral epiphysis

- occurs in adolescence
- displacement occurs through physis
- common in overweight males
TREATMENT: internal fixation, avascualr necrosis

3

Fracture of femoral neck

- Intracapsular (subcapital or transcervical)
- Extracapsular: intertrochanteric

DIAGNOSIS: affected limb is shortened and externally rotated

4

Subcapital fracture

- Risk of avascular necrosis

TREATMENT:
- internally fixed if undisplaced
- arthroplasty if displaced

5

Intertrochanteric fracture treatment

- internal fixation

- elderly patient should be mobilised to prevent risk of recumbancy

6

Femoral fracture in children: treatment option

- Gallows traction up to 3 yo
- thomas splint
- Hip Spica
- Flexible intramedullary nails

7

Midshaft fracture treatment

Intramedullary nailing

8

Supracondylar fracture treatment

- Nail or plate

9

Patella fracture

- by direct force or sudden quadriceps contraction

- TREATMENT
- internally fixed if displaced, typically by wiring

10

Osgood Schaltter's disease

- in active adolescent: overuse injury
- treated with activity modification
- due to inflammation of tibial tubercule

11

Patella dislocation

- teenage girls
- associated with patella maltracking and shallow sulcus
- TREATMENT: reconstructive surgery if recurrent

12

Knee dislocation

- in major trauma

TREATMENT
- immediate closed reduction and splintage
- monitor vascular status
- surgical reconstruction of stabilising ligaments

13

Medial collateral ligament injury

- common

TREATMENT
- rest, rehabilitation

14

Psterolateral corner injury

- lateral collateral ligament, biceps femoris and fascia lata
- check fibular nerve function
TREATMENT: surgical repair

15

Posterior cruciate ligament injury

- due to tibia being forced backward with knee in flexion
- recognized by reduced stepoff, or "tibial sag"
- may require surgical reconstruction

16

Anterior cruciate ligament injury

- twisting injury on fixed foot
- may be associated with meniscal injury
- surgical reconstruction

17

Meniscal injury

- rotational stress on flexed, weight-bearing knee
- potentially causes ongoing pain, clicking, locking
- surgical repair or excision

18

Tibial plateau fracture treatment

Internally fixed to restore joint congruity

19

Tibial fracture

- Torsion, axial compression or direct force

TREATMENT: intramedullary nailing

- beware compartment syndrome: anterior compartment most commonly affected

20

Tibial fracture in children

- treated with casting

- if need internal fixation: plating instead of nails to avoid growth plate damage with nailing

21

Ankle fracture

- Sites of injury: medial malleolus, lateral malleolus, syndesmosis

- casting vs internal fixation

22

Distal tibial physeal injury in children

- closed reduction and casting if extra articular

- internal fixation if articular displacement

23

Talus fracture

- through talar neck
- risk of avascular necrosis

24

Calcaneal fracture

- fixation depends on articular congruity and loss of height

25

Tendo achilles rupture treatment

- plantar flexed cast or surgical repair

26

Lisfranc fracture-dislocation treatment

- reduction and fixation if displaced

27

Metatarsal and toe injuries

- reduction and fixation for: dislocation, displacement, instability