# management

Question 1

extracapsular hip fractures management =

Answer 1

internal fixation with DHS/ compression

if subtrochanteric = pre-op Thomas spling

Question 2

management of intracapsular hip #

Answer 2

THR or hemiarthroplasty

Question 3

management of extra articular non - distal femur #

Answer 3

IM nail

Question 4

management of extra articular distal femur #

Answer 4

plating

Question 5

management of intraarticular distal femur #

Answer 5

anatomical reduction, rigid fixation with plates and screws

Question 6

management of femoral shaft #

Answer 6

femoral nerve block
Thomas splint
if unstable = IM nailing

Question 7

management of prox tibia intraarticular #

Answer 7

temp spanning and ext fixation (if sig soft tissue damage)
anatomical reduction and rigid fix
often TKR

Question 8

management of prox tibia extraarticular #

Answer 8

temp span and ext fixate if sig soft tissue injury

anatomical reduction rigid fixate

Question 9

management of <50% displaced and <5degree angulation tibial shaft #

Answer 9

knee cast

Question 10

management of comminuted and open tibial shaft #

Answer 10

sx stabilisation

IM nailing with plastic Sx assistance or ext fixate

Question 11

management of extraarticular non distal # of distal tibia

Answer 11

IM nail

Question 12

management of extraarticular distal tibial #

Answer 12

plate

Question 13

management of non displaced stable distal tibial #

Answer 13

conservative Rx

Question 14

management of Pilon #

Answer 14

Emergency
early int fix if soft tissue ok, if not = bridging ext fixate with delayed int fix
ORIF
CT for other injuries

Question 15

management of isolated distal fibular ankle

Answer 15

walking cast / splint for 6 weeks

Question 16

management of distal fibula # with deltoid lig rupture

Answer 16

ORIF with plates and screws

mortise AP xray to check for talar shift

Question 17

management of bimalleolar distal fibula #

Answer 17

ORIF with plates and screws

mortise AP xray to check for talar shift

Question 18

dont thomas splint distal femur supracondylar # because

Answer 18

leads to disimpaction of # due to pull of gastroc on distal fragment

Question 19

management of minimally displaced medial malleolus # of tibia

Answer 19

conservative

walking cast / splint for 6wks

Question 20

management of calcaneal # =

___ should be checked

Answer 20

ORIF debated

spinal injury

Question 21

management of displaced talar fracture

Answer 21

closed or open reduction and screw fixation

Question 22

management of Lisfranc (base of 2nd MT) #

Answer 22

CT scan if doubt because xray can be normal

closed/open reduction with fixation with screws

Question 23

management of base of 5th MT #

Answer 23

walking cast/wearing stout boot for 4-6wks

Question 24

management of proximal diaphysis of 5th MT (Jones #)
displaced in active =
non union =
stable =

Answer 24

displaced # in active = fixate with one screw
non union = bone grafting and fixation
stable = moon boot

Question 25

1st MT # management

Answer 25

fixation

Question 26

management of lesser MT #

Answer 26

minimal displacement = treated conservatively with cast | multiple displaced #s = stabilised with k wires

Question 27

management of 2nd MT #

Answer 27

cast until pain subsides

Question 28

management of extra art toe #

Answer 28

protect in stout boot | open = debride and stabilise with wires

Question 29

management of toe dislocations

Answer 29

closed reduction and either neighbour strapping or wiring

Question 30

management of intra art # of base of proximal phalanx of hallux

Answer 30

reduction and fixation | if open = debridement and stabilise with wires

Question 31

management of minimally displaced prox humerus #

Answer 31

conservative with sling

Question 32

management of persistently displaced prox humerus # =

Answer 32

internally fixate

Question 33

management of head splitting # or 3/4 part fracture of proximal humerus

Answer 33

arthroplasty considered

Question 34

most common pattern of fracture of proximal humerus

Answer 34

surgical neck # with medial displacement of humeral shaft due to pectoralis major pull

Question 35

#s dancers get :

Answer 35

MT avulsion #

Question 36

`wrist drop and loss of sensation in 1st dorsal web space is due to

Answer 36

radial nerve damage

Question 37

management of humeral shaft #

Answer 37

functional humeral brace to compress and stabilise polytrauma = int fix wit hIM nail, plate or screw non union = plating and bone graft

Question 38

management of intra art distal humerus #

Answer 38

ORIF with anatomical reduction and rigid fixation | elbow replacement considered in highly comminuted

Question 39

management of olecranon #

Answer 39

ORIF | simple transverse avulsion # = fixed with tension band wiring

Question 40

management of radial head and neck #s

Answer 40

min displaced marginal # = conservative Sx if displaced fragment blocks extension comminuted = excise +/- replacement

Question 41

management of epicondyle #

Answer 41

fixed screw

Question 42

management of coronoid #

Answer 42

if large = ORIF with screw

Question 43

management of nightstick #

Answer 43

conservative

Question 44

management of ulna and radius together #

Answer 44

ORIF with plates and screws kids w minimal angulation = plaster very angulated with intact periosteum after reduction and unstable in 1 direction = MUA and plaster

Question 45

management of Monteggia # dislocation (ulnar # with radial head dislocation)

Answer 45

ORIF of ulnar # | and once reduced radial head will reduce

Question 46

management of Galeazzi # dislocation (radial # with dislocation of ulna at distal radio ulnar J)

Answer 46

ORIF of radial # | and once reduced ulna head will reduce

Question 47

management of Colles # (extra - art distal radius # with dorsal displacement of distal radius)

Answer 47

stable min displaced/angulated = plaster displaced simple = MUA displaced, comminution = MUA k wiring and ORIF

Question 48

complications of Colles #

Answer 48

median nerve compression EPL rupture CRPS loss of grip strength

Question 49

dinner fork deformity =

Answer 49

Colles #

Question 50

management of Smith # ( extra art of distal radius # with volar disp)

Answer 50

ORIF with plate and screws

Question 51

Smith # = __ failure of radius | Colles = ___ failure of radius

Answer 51

``` smith = flexion colles = extension ```

Question 52

management of intra art radial # with dorsal or volar rim # (Bartons #)

Answer 52

ORIF

Question 53

management of comminuted intra art distal radial #

Answer 53

externally fixate +/- k wires

Question 54

management of scaphoid #

Answer 54

``` splint wrist undisplaced # = plaster cast for 6-12wks displaced # = special compression screw non-union = screw fixate and bone graft 4 xrays ```

Question 55

management of 3rd/4/5th MC #

Answer 55

conservative

Question 56

management of 5th MC neck #

Answer 56

up to 45 degree angulation tolerated | manipulation with neighbour strapping or k wire stabilisation

Question 57

management of phalangeal #

Answer 57

sig displaced/angulated = MUA / digital nerve block unstable # = k wire / fixate with small screws interarticular # = k wire or small screws