lower limb fracture Flashcards
(16 cards)
when is an ankle x-ray required
pain in the malleolar zone and one of the following:
- bony tenderness at the lateral malleolar zone
- bony tenderness at the medial malleolar zone
- inability to walk four weight bearing steps
features of hip fracture
pain
shortened and externally rotated leg
location of intracapsular hip fracture
from the edge of the femoral head to the insertion of the capsule of the hip joint
location of extracapsular hip fracture
can either be trochanteric or subtrochanteric
classification system for hip fractures
Garden system
management of an intracapsular hip fracture
undisplaced: internal fixation or hemiarthroplasty if patient unfit
displaced: arthroplasty or THR if patient previously independent
management of extravascular hip fracture
intertrochanteric fracture: DHS
subtrochanteric fractures: IM nail
most common metatarsal fractured
proximal 5th metatarsal
types of fifth metatarsal fractures
proximal avulsion fracture (pseudo-jones): most common type- at the proximal tuberosity and associated with ankle sprain
jones fracture: transverse fracture at the metaphyseal-diaphyseal junction
most common site of metatarsal stress fracture
2nd metatarsal shaft
features of metatarsal fracture
pain and bony tenderness
swelling
antalgic gait
investigations for metatarsal fractures
x-ray: to tell is displaced or not
isotope scan or MRI: stress fractures can appear normal on x-ray
features of patella fracture
swelling and bruising
pain
if patient can straight leg raise the extensor mechanism is intake
investigations for patella fracture
x-ray
management of patella fracture
undisplaced fractures: managed non-operatively in hinged knee brace for 6 weeks
displaced fractures and those with loss of extensor mechanisms: operative management with tension band wire or inter-fragmentary screws or cerclage wires
management of ankle fractures
promptly reduced to remove pressure over skin causing necrosis (closed reduction under sedation)
young patients + unstable injury= surgical repair
elderly patient= conservative
