MSK Trauma

Question 1

Non displaced fracture

Answer 1

In anatomical position

Question 2

commented fracture

Answer 2

More than 2 pieces

Question 3

osteotomy

Answer 3

surgery where part of the bone must be removed

Question 4

Iatrogenic

Answer 4

when bone is fractured unintentionally during a surgery

Question 5

Stages for fracture healing

Answer 5

Hematoma
soft callus
hard callus
remodeling

Question 6

Goals of fracture treatment

Answer 6

obtain reduction
maintain reduction
obtain union
rehabilitation

Question 7

What fractures do need surgery

Answer 7

open fractures

most displaced femoral fractures

most displaced forearm fractures

all irreducible dislocation and fracture dislocations

Question 8

Acromioclavicular Joint Dislocation

Answer 8

Mechanism
- Falls
- Direct trauma
Diagnosis
-PE
- Xray
Treatment
- Sling
- Surgical repair

Question 9

Clavicle

Answer 9

•Mechanism

–Indirect

–Direct

• Diagnosis
• Treatment

–Min displacement

-sling

–Displaced - ORIF

Question 10

Humerus

Answer 10

•Mechanism

–Direct blow

–Indirect

–GSW

•Types

–Displaced

–Non-displaced

deltoid and pectoralis major may contribute to displacement

Question 11

Distal Radius

Answer 11

• Common upper extremity fracture
• Min displaced – closed treatment

Question 12

Answer 12

Forearm

• Mechanism: falls, direct blow, GSW
• Single bone, min displaced – closed treatment

Question 13

Answer 13

Hip Dislocation

• Major trauma•Mechanism–Falls–MVA
• Treatment – immediated closed reduction
• Complication - AVN

Question 14

Answer 14

• Age group: Elderly•Risk factor: osteoporosis
• Mechanism: falls
• Treatment: Surgical
• Complications–Loss of fixation–AVN

Question 15

Answer 15

Intertrochanteric Fracture

• Age group: Elderly
• Risk factor: osteoporosis
• Mechanism: falls
• Treatment: Surgical
• Complications–Loss of fixation–Leg length inequality

Question 16

Answer 16

Knee dislocation

• Mechanism: MVA, sports, falls
• Treatment–Early: immediate reduction–Definitive: ligament reconstruction
• Complications: neurovascular injury

Question 17

Knee Anatomy

Answer 17

• 4 ligament structures- •ACL•PCL•MCL
• LCL & PLC (lateral side)•Popliteus•Biceps femoris•Popliteofibular lig.•ITB•Capsule•

Patella tendon

Question 18

Answer 18

Tibia Fracture

• Mechanism: direct, indirect
• Min displaced – closed treatment
• Displaced - surgery

Question 19

Answer 19

Ankle

• Common lower extremity fracture
• Mechanism: torsion•Non-displaced – immmobilization
• Displaced - surgery

Question 20

Ankle Sprain

Answer 20

• Common lower extremity injury
• Mechanism–Inversion–Eversion
• Treatment–Non-surgical–Surgical

Question 21

Lateral Collateral Ligaments

Answer 21

• Anterior Talofibular Ligament–First injured in lateral sprain with plantarflexed ankle (most common)
• Calcaneofibular Ligament–Strongest lateral ligament–First injured in lateral sprain with dorsiflexed ankle
• Posterior Talofibular Ligament

Question 22

Medial collateral ligaments

Answer 22

•Superficial–Superficial talotibial, naviculotibial, and calcaneotibial fibers–•Deep–Deep anterior talotibial and posterior talotibial fibers from posterior colliculus to talus–Strongest portion of the Deltoid ligament

Question 23

Answer 23

Pelvis fractures

• Major trauma•Potentially life-threatening – hemorrhage
• Treament–External fixation–ORIF

Question 24

Answer 24

Cervical spine

• Potentially life threatening•Life altering
• Early and accurate diagnosis critical
• Spinal cord injury common
• Treament principles–Stability–Preservation of function
• Treatment– collar–Halo–Surgery

Question 25

Mechanism of spine injury

Answer 25

* Compression–Axial loading–Football–Diving * Hyperextension–Falls * Hyperflexion–Motor vehicle accidents

Question 26

Answer 26

Dislocation traction to acheive reduction definite treatment: arthrodesis

Question 27

Spinal cord injury

Answer 27

* Lifespan–Overall 86% at 10y–\>29, 50% at 10 yr * Immobilization * Lifestyle changes * Physical complications * $600,000-1,000,000 per patient

Question 28

Answer 28

Thoracolumbar spine injuries * Mechanism–Falls–MVA * Often assoc with multiple trauma * Spinal cord injury common

Question 29

Answer 29

Burst fracture

Question 30

Answer 30

Pediatric distal radius * Common injury * Mechanism: fall on outstretched hand * Usually treated with closed reduction and casting

Question 31

Answer 31

Pediatric forearm * Mechanism: falls * Treament–Closed reduction–Flexible nails in older children * Complication: loss of forearm rotation

Question 32

Answer 32

Pediatric growth plate fractures * Usually treated closed * Accurate reduction is goal * Complication: growth disturbance

Question 33

Growth arrest

Answer 33

* Uncommon * Results from injury to physis * Treatment–Excision of bar–Osteotomy to correct deformity

Question 34

Answer 34

Pediatric femur fractures * Common injury * Must exclude child abuse * Usually treated in spica cast in young children * Flexible nails in older children

Question 35

Answer 35

Ped. distal femoral physeal fracture * Mechanism: falls, MVA * Treatment: reduction and pinning * Complication: growth disturbance

Question 36

Mechanism of distal femoral physical fracture

Answer 36

•Mechanism: falls, direct or indirect trauma•Treatment–Reduction and casting–Flexible nails in older children