Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UdeM PS questions > Main 0 (fracture, luxation) > Flashcards

Main 0 (fracture, luxation) Flashcards

(82 cards)

Start Studying
1
Q

Describes safe position of immobilization

A

Wrist in 20 to 30° extension,
MCP joint in 70 to 90° flexion, Interphalangeal joints in full extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indications for operative management for MC head fracture (4)

A
  • > 25% involvement of articular surface
  • > 1 mm of articular step off
  • Malrotation
  • échec de réduction fermée
  • Lésion concomittante à autre structure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Surgical management of simple and communicated metacarpal head fractures

A

Simple
* Minicondylar plate or screw
* Buried headless compression screw
* k-wire (more stiff)

Comminuted: K-wire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

qu’est-ce qu’une ‘‘vrai’’ blessure du boxer

A

lésion de la bandelette sagittale de D5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indication for surgical management of metacarpal **neck **fracture (4)

A

Angular deformity:
D2-D3: 10-15°
D4: 30-40°
D5: 50-70°

Malrotation

Shortening >3mm in Janis (vs 5mm in CME)

Extensor lag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Maneuver for metacarpal neck reduction

A

Jahss maneuver

Flex MCP 90° to relax intrinsics
Flex PIP 90°
Apply dorsal directed force to P1 and volar directed force to proximal MC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for reduction of metacarpal shaft fractures (3)

A

1.Angulation
Any angulation degree D2 and D3
More than 20° angulation D4
More than 30° angulation D5

2.Malrotation
3.Shortning >3mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define a Bennett fracture

A

Unstable IA single fragment fracture MC base of thumb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ligament that holds fragment in place in Bennett fracture

A

Volar Beak Ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Forces that causes displacement of Bennett fracture (4)

A
  1. APLpulls proximal fragment proximally
  2. **Adductor pollicis **pulls distal fragment in adducted and supinated position
  3. EPL: tire proximal, radial et dorsal le fragment distal
  4. APB and FPB pulls distally causing apex dorsal angulation and subluxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Reduction maneuver for Bennett fracture (4 movements)

A

TAPE:
Traction
Abduction
Pronation
Extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define reverse Bennett fracture

A

Unstable IA fracture of MC base D5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Forces that deform reverse Bennett fracture, which is strongest? (3)

A

ECU (especially causing proximal and dorsal migration)
FCU
ADM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define Rolando fracture

A

Comminuted IA fracture of thumb MC base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Surgical management of Bennett fracture

A

if <20% IA involvement: closed reduction + K wire
ORIF if >2mm displacement after attempted close reduction, use lag screws

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surgical management of reverse/baby Bennett

A

Closed reduction + pinning

Reduction: Longitudinal traction + pressure on dorsal aspect of the base of D5 MC followed by passive wrist extension

ORIF: if delayed treatment, unsuccesfull closed reduction, multiple CMC joint fracture dislocation, associated dorsal shear fracture of the hamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Method of healing of tuft fractures

A

Fibrous union

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of symptomatic non union of distal phalanx

A

Open volar midline approach
Bone graft + kwire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define Seymour fracture

A

Open pediatric fracture of distal phalanx epiphysis
SH type 2
Proximal mail matrix interposed in fracture site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Consequences of failure to recognize Seymour fracture (3)

A

Nail plate deformity
Physeal arrest
Chronic OM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classification of phalangeal head fracture

A

London classification

Type 1: stable fracture sans déplacement
Type 2: Unicondylar unstable fracture
Type 3: Bicondylar comminuted fracture

***Weiss-Hasting est une classification spécifique des fracture unicondylaire

Type I consists of stable fractures without displacement; type Il includes unicondylar, unstable fractures; and type III fractures are bicondvlar or comminuted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Angulation of proximal phalanx shaft fracture, explanation

A

Apex volar
Les intrinsèques vont être des extenseurs du fragment distal, et des fléchisseurs de la MP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fx base de P2: quel type d’apex et pourquoi?

A

Apex dorsal car insertion du FDS fait fléchir fragment distal
et insertion du central slip fait étendre fragment proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fx mid/distal P2: quel type d’apex et pourquoi?

A

Apex palmaire dès que la fracture est distale à l’insertion des FDS qui vont venir fléchir le fragment proxiaml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Treatment of proximal and middle phalanx shaft fracture if displaced vs non displaced
Non displaced: buddy taping and/or splinting Displaced with adequate reduction: Immobilise in SAFE position Irreducible: K-wire vs interfragmentary screw vs wiring vs plate (stiffness++)
26
Surgical indication for phalanx base fracture
>25° angulation
27
Deformity associated with middle or proximal phalanx base fracture (3)
Pseudoclawing Hyperextension at MCP and extension lag at PIP
28
Define Pilon fracture
Comminuted IA base of middle phalanx fracture
29
Indication for operative treatment of base of P1 (2) intraarticulaire
Articular step off >2mm Joint instability
30
Criteria for stability of base of middle phalanx fracture
Involves <40% of articular surface
31
Treatment of base of P2 volar or lateral fracture
Buddy tapping
32
Implication and treatment of dorsal base of P2 fracture
Central slip avulsion Extension splinting PIP 6 weeks
33
Fixation options for unstable fracture of base of P2 (4)
K-wire Screw if fragment allows Suzuki frame Hemihamate arthroplasty
34
Indication for Suzuki frame from base P2 fracture
Comminuted intra-articular fracture of PIP
35
Mechanism of action of the Suzuki frame
Ligamentotaxis
36
Indication for hemihamate arthroplasty for base P2 fracture
If dorsal cortex intact but fracture involves >50% PIP and impaction
37
What is the "Cam effect"
translation of rotary motion into linear motion flexion of MCP joint tightens collateral ligaments compared to extension
38
Describ simple vs complex dorsal MCP subluxation
Simple: volar plate intact Complex: volar plate impingement: widening of point space on x ray
39
Reduction of simple dorsal MCP subluxation
Flexion of wrist (relax flexors) Volar pressure on P1 Encourage early ROM *Do not do traction or hyperextension as can pull volar plate into joint and convert simple to complex subluxation
40
Reduction of complex dorsal MCP subluxation + immobilisation
Surgical: must divide volar plate surgically Immobilise MCP in 30° flexion for 2 weeks followed by dorsal blocking 10°
41
Grade of MCP collateral ligament injury and management (3)
Grade 1: pain without laxity (splint) Grade 2: laxity with passive stress stop at 60° (splint) Grade 3: ligament avulsion no endpoint on stress test (repair)
42
Splint for grade 1 and 2 MCP collateral ligament rupture
Immobilisation in 30° flexion
43
Thumb MCP collateral ligaments, position in which they are tight/relaxed
Proper collateral ligaments: tight in flexion and loose in extension Accessory collateral ligament (inserts volarly on sesamoid bone): tight in extension, loose in flexion
44
Thumb MCP UCL avulsion definition and treatment + 2 indications chirurgicales
UCL avulsion at its insertion Tx: immobilisation If fracture involves >10° articular surface and >2mm displacement --> fixation
45
Describe UCL Stener lesion
Complete UCL rupture Adductor aponeurosis becomes interposed between PROXIMAL-UCL and base of proximal phalanx
46
Thumb UCL injury treatment
Partial rupture: 4 weeks cast immobilization followed by 2 weeks splint for AROM Complete rupture or Stener: surgical repair
47
UCL repair technique thumb MCP (2)
Bone anchor Pull out suture 4 weeks post-op immobilisation
48
Entity for chronic UCL thumb injury and definition and symptoms
Gamekeeper's thumb Progressive UCL attenuation Chronic instability and weakness
49
Gamekeeper's thumb treatment
Direct UCL repair if it can be mobilized from scar Free tendon graft Arthrodesis if MCP OA
50
Structures that can block a thumb MCP dislocation reduction (3)
Volar plate FPL sesamoid bone
51
Types of PIP dorsal dislocation (3)
Type 1: hyperextension, partial articulation Type 2: complete dorsal dislocation no joint articulation Type 3: fracture dislocation
52
Stable vs unstable PIP dorsal fracture dislocation
Stable if involves <40% articular surface
53
Reduction technique for PIP dorsal dislocation
Extension stress + pressure on proximal middle phalanx to slide it over joint
54
Immobilization of type 1 and 2 dorsal PIP dorsal dislocation after reduction
If stable: buddy tape If unstable: dorsal blocking splint in 10° flexion
55
Immobilization of type 3 dorsal PIP dorsal dislocation after reduction
Stable: 3 weeks dorsal blocking split Unstable: -Dorsal blocking splint if lateral stability intact and is stable with less than 30° extension blocking -Suzuki frame if comminuted fracture -ORIF if large single volar fragment -Volar plate arthroplasty (if <40% IA) combine with pinning in 20-30° flexion
56
What is the principle of "ligamentotaxis"
Mise en tension des ligaments péri-articulaire permettent d'optimiser la guérison anatomique de la fracture intra-articulaire
57
Name special metacarpal imaging views (3)
1. Brewerton view 2. Roberts view 3. Betts view
58
Name 2 advantages and disadvantages of percutaneous pinning
Advantages 1. minimizes soft tissue trauma 2. less costly 3. Flexible technique pattern Disadvantage 1. Less stable than ridgid fixation 2. Infection risk 3. Reduction more technically challenging than open
59
Name 2 advantages and disadvantages of plate fixation
Advantages 1. More ridgid and stable 2. open approach allows better reduction Disadvantages 1. soft tissue stripping 2. Increased risk of extensor tendon adhesion 3. Need adequate soft tissue coverage 4. More costly than k-wire
60
Name 2 advantages and disadvantages of lag screw
Advantages 1. less soft tissue stripping 2. less prominent on tendons Disadvatanges 1. less rigid than plate 2. limited fracture pattern application 3. requires soft tissue dissection vs exfix or k-wire
61
Name 2 advantages and disadvantages of intramedullary screw
Advantages 1. Ridgid fixation with minimal soft tissue dissection 2. Anterograde or retrograde is feasible Disadvatanges 1. Rotational control is difficult 2. Hardware removal challenging if infection or refracture
62
Name 2 advantages and disadvantages of external fixation
Advantages 1. No soft tissue disruption 2. Spanning of segments of bone loss 3. Distration of joint is needed dor reduction Disadvantages 1. Risk of pin-site infection 2. Risk of adhesions 3. Bulky hardware (ADLs difficult) 4. Expensive 5. Overdistraction
63
What are the 3 phases of fracture healing
1.**Inflammation** - immediate lasts a few days - hematoma formation -osteogenis precursors 2.**Repair** - <24hrs and peaks at 2-3 weeks - collagen deposition - cartillagenous callus formation - endochondral ossification 3.**Remodelling** - months to years - lamellar bone formation - resorption of callus
64
During which phase of fracture healing does hematoma formation occur
Inflammation (immediately to a few days)
65
During which phase of fracture healing does endochondral ossification occur
Repair (>24hrs and peaks at 2-3 weeks)
66
During which phase of fracture healing does resorption of callus occur
Remodeling (months ot years)
67
During which phase of fracture healing does lamellar bone formation occur
Remodeling phase (months to years)
68
Which drugs should be avoided in the setting of acute fracture
NSAIDS - studies have shown increased rates of nonunion. *NSAIDS disrupt the inflammation phase of fracture healing*
69
You consent a patient who has a metacarpal fracture. What complications should you mention
* Infection * Malunion * Angulation * Shortning * Nonunion * Ankylosis
70
Describe the 2 patterns of fracture non-union et 3 facteurs de risque
Atrophic: Lack of callus. Requires bone grafting Hypertrophic: Callus has formed. Requires more rigid fixation FDR: réduction instable, plaie contaminée
71
Which factors are associated with loss of motion in the context of hand fractures
1. Tendon adhesions 2. Capsular contracture 3. Immobilization >4 weeks 4. Joint injury 5. Multiple fractures in one digit 6. Crush injury
72
In which finger would you avoid a metacarpal head implant arthroplasty as your management option for treatment of a fracture
Index finger (implant failiure common because of sheer stress)
73
Which mechanism of injury is most likely to result in a metacarpal neck fracture
Axial load applied to clenched fist
74
What explains the apex dorsal angulation seen in metacarpal neck fractures
Intrinsic muscles lie volar to the axis of rotation of the MP and maintain a flexed head posture
75
Which fingers can better compensate for metacarpal fracture angulation and why?
4th and 5th fingers Because their CMC joints have more mobility in sagittal plane (20-30o)
76
When should you attempt to reduce a metacarpal shaft fracture?
- Any degree of angulation of index and middle - >20o angulation of ring finger - >30o angulation little finger
77
Name 5 surgical treatment options for metacarpal shaft fractures
1. Kwire 2. Tension band wiring 3. Cerclage 4. Intramedullary fixation 5. Compression screws (lag screw) 6. Plate fixation 7. External fixation 8. Bioabsorbable fixation
78
What are the rules of 2 of lag screws (5)
- 2 vis - 2mm - Au moins a une distance de 2 têtes de vis de la fx - 2 axes (spiralées) - Longueur fx au moins 2x largeur de l'os
79
Pour chaque degré d'angulation et de shortening, combien de déficit d'extension?
80
Nommer 5 structures qui stabilisent la MP
* Plaque palmaire * Ligament métacarpien transverse profond * Ligament collatéral accessoire * Fléchisseurs et extenseurs
81
Nommer les 4 structures impliquées dans un Kaplan lesion
FDP (ulnaire) Lumbrical (radial) Ligament superficiel transverse (profond) Ligament natatoire (superficiel)
82
2 complications de luxation MP tardive ou traumatique
Ostéonécrose de la tête du méta Arthrose

UdeM PS questions (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions