MDD/fractures

Question 1

What fracture does Weber’s relate to

Answer 1

fibular

Question 2

Describe webers

Answer 2

A - just the tip, no syndesmosis involvment (inverseion, stable). Still may need ORIF.

B- fracture diagonal up fibular may of may not have syndesmosis involvment (eversion, ?stable). Management decided by senior.

C - High on fibular, syndesmosis is stretched (side-force, ?not stable). ORIF

Question 3

What fracture does Garden relate to

Answer 3

NOF

Question 4

Describe Gardens

Answer 4

1. * Impacted slightly crooked fracture, bone still mainly intact. No displacement. IM screw
2. * Fracture all the way through NOF not displaced in anyway. IM screw
3. * Fracture complete and head slightly displaced. Loads of angulation in trabecular network. Hemi/full arthroplasty
4. * Facture complete head off-ended. Hemi/full arthroplasty

1 2 give it a screw 3 4 gonna need a bit more.

Question 5

What fracture does salter-harris relate to

Answer 5

Paeds fracture involving epiphyseal plate

Question 6

describe salter harris

Answer 6

1. * Growth plate only - can’t see on x ray
2. * Through GP and metaphysis - most common
3. * Through GP and epiphysis
4. * Through GP E and M
5. * Crush - can’t se on x-ray

E->G->M

Question 7

What does Gustilo & Anderson fracture relate to

Answer 7

Open fracture following debridement

Question 8

Describe Gustilo and anderson

Answer 8

1. * Simple fracture + wound <1cm
2. * Simple fracture + wound >1cm
3. * Compound fracture + any wound size, broken into 3

a. Some coverage of bone -> allow soft tissue to recover then internal fixation, cover with existing soft tissue. Can apply to type 1 and 2 as well
b. Bare bone can’t be covered with remaining soft tissue -> external fixation and plastics input, ABx
c. Arteries damaged -> ugrent vascular input, Abx

Question 9

Management of Hip #

Answer 9

Question 10

Define galeazzi #

Answer 10

Radius # and dislocations of distal radial-ulnar joint

Question 11

Define Monteggia #

Answer 11

Proximal ulnar # with dislocation of the radial head

Question 12

How to remember Monteggia and galeazzi

Answer 12

MU GR Monteggia = Ulnar #

Also monteggiA = proximal

Galeazzi = Radial #

Also galeazZi = distal

Question 13

Define Smith’s #

Answer 13

Distal radius # with volar/palmar angulation

Caused by falling on a flexed hand

Remember S–>P (palmar)

Question 14

Define Colle’s #

Answer 14

Radius # with dorsal angulation

Caused by falling on an extended hand

If pt not elderly female is osteoporosis describe as colle’s form/FOOSH

Remember C to D to E (extended hand)

Question 15

Principles of management of scaphiod #

Answer 15

* The more proximal the # the more likely malunion is

* Malunion = AVN

* The high the risk of AVN the more likely the pt is to need surgery (screw)

* Blood supply comes from the distal end of the scaphiod

* If on initial injury no # seen –> splint and re x-ray in 2/52

Question 16

what does Schatzker relate to

Answer 16

Tibial #

Question 17

Describe Schatzker

Answer 17

1. * The lateral nub is fractured no displacement
2. * The lateral nub is fractured and depression of lateral plateau
3. * In lateral compartment no obvious fracture but completely depressed
4. * Medial plateau only pathology either fracture or depression
5. * Fracture of both medial and lateral plateau
6. * Fracture of tibia plateau and shaft

Question 18

Types of Vertebral #

Answer 18

* Spondylolysis/spondylolisthesis

* Jefferson’s fracture

* Hangmans fracture

* Odontoid fracture

* Clay Shoveler’s fracture

* Tear drop fracture

* vertebral body compression fracture/wedge

Question 19

Describe fractures relating to spondylolysis/spondylolisthesis

Answer 19

Spondylolysis - stress fracture in pars articularis

Spondylolisthesis - above and sliding of vertebra

Question 20

Describe Jeffersons #

Answer 20

C1 vertebral # caused by a compression force to the top of the headthe fracture is of the articular surface relating to the occipital condyles

best method of imaging is an open mouth view x ray

Question 21

Describe a Hangmans fracture

Answer 21

Caused by a hyperextension of the neck,fracture is of the neural arches of C2

most easily seen on a leteral c-spine x-ray

Question 22

Describe an Odontoid fracture

Answer 22

fracture of the odontoid peg caused by hyper extension or flexion of the neck or blunt force taruma to the neck

Type 1: Avulsion fracture of just the tip - STABLE

Type 2: at the base of the dens - UNSTABLE (most common)

Type 3: involves the body of C2 - UNSTABLE

Question 23

Describe a Clay Shoveler’s fracture

Answer 23

MOI: avulsion by the supra spinous ligament in hyperflexionoblique fracture of the spinous process

Question 24

describe a Tear drop fracture

Answer 24

MOI: sudden and forceful flexionCauses # of the anterior, inferior corner of the vertebral body

Question 25

Describe vertebral body compression fracture/wedge

Answer 25

Caused by osteoporosis, tumours and trama can appear wedge shaped and cause dislocation

Question 26

What is Bennet's fracture

Answer 26

Fracture of the base of the first metacarpal Caused by punching something Usually 1st metacarpal also dislocated and 1st MCP involved