ORTH SCP

Question 1

Top 3 injuries associated with scapula fracture

Answer 1

injury of
head
ribs
lungs

Question 2

pulmonary injuries occur in how much of patients with scapulrar fracture

Answer 2

1/3

Question 3

most scapular fracture is treated with

Answer 3

sling

Question 4

surgery for scapular fracture is indicated when

Answer 4

there is involvement of glenoid with a major particular step off or if there is a glenoid rim fracture or subluxation of the joint

Question 5

most commobly dislocated large joint

Answer 5

shoulder specifically glenohumeral joint

Question 6

most dislocations of the glenohumeral joint are

a. anterior
b. posterior
c. lateral
d. medial

Answer 6

A

Question 7

injuries(avulsion) of the anterior inferior glenoid laBrum is called

Answer 7

Bankart lesion

Question 8

impaction fractures of the Humeral Head

Answer 8

Hill-Sachs lesion

Question 9

3 lesions associated with shoulder dislocations

Answer 9

Bankart lesion
Hill Sachs
Rotator cuff

Question 10

nerve most at risk with shoulder dislocations

Answer 10

axillary nerve

Question 11

if elderly patient with shoulder dislocation is unable to raise the arm after reduction of shoulder, the reason is probably

Answer 11

rotator cuff tear

Question 12

if young patient with shoulder dislocation is unable to raise the arm after reduction of shoulder, the reason is probably

Answer 12

axillary nerve injury

Question 13

dislocation rate of shoulder dislocations if the patient is younger than 20 years

Answer 13

90%

Question 14

these type of shoulder dislocations are associated with seizure or electric shock

Answer 14

Posterior dislocations

Question 15

what is the most important plain radiography view for shoulder dislocations

Answer 15

axillary view

Question 16

what should be done for a patien lt with shoulder dislocation when axillary view cannot be obtained?

Answer 16

computed tomography

Question 17

treatment of shoulder dislocations

Answer 17

closed reduction followed by a short period of sling immobilization

Question 18

historical system of classification of proximal humeral fractures

Answer 18

Neer’s classification

Question 19

4 parts of the humerus according to Neer’s classification

Answer 19

He let go of her

humeral head
greater tuberosities
lesser tuberosities
humeral shaft

Question 20

3 factors that determine treatment of proximal humeral fracture

Answer 20

displacement of the fracture fragments
amount of angulation of the fracture
amount of comminution

Question 21

indication of ct scan in humeral fracture

Answer 21

suspicion of intra articular fracture

Question 22

tx of majority of proximal humerus fractures

Answer 22

sling immobilization
early shoulder motion
pendulum exercises

Question 23

How long after proximal humers fracture should physiotherapy be done to prevent stiffness? (esp in the elderly)

Answer 23

2 weeks

Question 24

what is the treatment of choice for proximal humerus fracture if therr is adequate bone stock and fracture can be successfully reduced

Answer 24

Open reduction internal fixation with plate and screw fixation

Question 25

older patients w/osteoporosis, comminuted fractures, head-splitting fractures and 4-part fracturrs or fracture dislocations are typically treated with

Answer 25

prosthetic replacemenr of the humeral head or hemiarthroplasty

Question 26

True about humeral shaft fractures a. majority of humeral shaft fracturrs can heal with nonsurgucal mgt b. radial nerve spirals around the humeral shaft and at risk of injury c. radial nerve palsy is manifeste as wrist drop d. most radial nerve injuries are neuropraxias

Answer 26

AOTA

Question 27

most radial nerve injuries after humeral shaft fractures are neuropraxias and function will return within

Answer 27

3-4 mos

Question 28

A spiral fracture of the distal one third of the humeral shaft is commonly associated with neuropraxia of the radial nerve and this is called

Answer 28

Holstein Lewis Fracture

Question 29

Criteria for acceptable alignment of Humeral.shaft fractures

Answer 29

less than 20deg anterior angulation less than 30deg varus/valgus angulation leas than 3cm shortening

Question 30

T/F radial nerve palsy is a contraindication to conservative treatment

Answer 30

F. not a contraindication

Question 31

Neer's classification: Surgical Neck

Answer 31

III

Question 32

Neer's classification: Greater tuberosity

Answer 32

IV

Question 33

Neer's classification: Anatomical Neck

Answer 33

I

Question 34

Neer's classification: Lesser tuberosity

Answer 34

V

Question 35

Neer's classification: Minimal Displacement

Answer 35

I

Question 36

Neer Classification humeral head fracture No fragments meet the criteria for displacement ( any fracture pattern less than 1cm displacement)

Answer 36

1 part

Question 37

Neer classification: one tuberosity is displaced and the surgical neck fracture is displaced, the remaining tuberosity is attached which produces rotational deformity (at least 1cm displacement)

Answer 37

three part

Question 38

Neer classification one segment is displaced which may be the greater tuberosity, lesser tuberosity, or articular segment at the level of anatomic neck or surgical neck

Answer 38

two part

Question 39

Neer classification both tuberosities, articular surface and shaft meet the criteria for displacement

Answer 39

four part

Question 40

diagnostic done to monitor recovery of radial nerve after humeral shaft fracture and ORIF

Answer 40

EMG

Question 41

mechanism of fractures of the distal humerus

Answer 41

fall onto the elbow or onto outstretched arm

Question 42

What's the most common fracture of the distal humerus?

Answer 42

Supracondylar fractures

Question 43

minimally displaced distal humerus fractures can be treated with

Answer 43

posterior long arm splint wirh the elbow typically flexed to 90deg

Question 44

severely comminuted distal humerus fractures can be treated with

Answer 44

elbow replacement

Question 45

common mechanism of elbow dislocations

Answer 45

typically occur with fall on outstretched hand

Question 46

Terrible triad of elbow dislocations

Answer 46

1. injury to the joint capsule and rupture of the lateral collateral ligament/ possible involvement of the medial collateral ligament 2. possible fractures of the radial head and 3.coronoid REC radil head elbow coronoid

Question 47

recommendations to avoid stiffness of the elbow for simple elbow dislocations

Answer 47

short term immobilization of about 7-10 days follwed by early range of motion

Question 48

characterized by a fracture of the radial head, dislocation of the distal radioulnar joint and rupture of the antebrachial interosseous membran

Answer 48

Essex-Lopresti fracture

Question 49

surgery is recommended for radial fractures when (4)

Answer 49

``` D DBW displaced fracture dislocation of the elbow blocks supination or pronation wrist pain ```

Question 50

radial head comminuted fracture management of choice

Answer 50

radial head replacement with metallic head implant

Question 51

mechanism of olecranon fractures

Answer 51

fall on flexed elbow

Question 52

tx of olecranon fractures, nondisplaced,

Answer 52

splint 45-90deg of flexion

Question 53

muscle that inserts into the olecranon

Answer 53

triceps

Question 54

tx of olecranon fracture

Answer 54

surgical fixation

Question 55

common mechanism of forearm fractures

Answer 55

fall on outstretched arm

Question 56

what is a nightstick fracture

Answer 56

isolatrd fracture of the ulna shaft

Question 57

mechanism of nightstick fracture

Answer 57

direct blow to the side of the forearm

Question 58

fracture of the proximal third of the ulna associated with radial head dislocation

Answer 58

Monteggia fracture

Question 59

fracture of distal third radial shaft associated wirh distal radioulnar joint injury at the wrist

Answer 59

Galeazzi fracture

Question 60

distal radius fracture causing dorsal displacement of the distal radius. Presents as dinner fork deformity

Answer 60

Colles fracture

Question 61

distal radius fracture causing volar displacement of the distal radius. a.k.a reverse colles smith

Answer 61

Smith's fracture

Question 62

are intra-articular fractures of the radial styloid process. The radial styloid is within the fracture fragment, although the fragment can vary markedly in size.

Answer 62

Chauffer's fracture Hutchinson fracture Backfire fracture

Question 63

Intr articular volar or dorsal fracture with associated dorsal subluxation/dislocation of the radiocarpal joint.

Answer 63

Barton's fracture

Question 64

the ff are true with forearm fractures a. every attempt should be made to rule out feactures that extend intra articularly into the wrist joint or involve the DRUJ b. Osteoporosis should be ruled out c. median nerve injury is possible d. loss of thumb extension from extensor pollicis longus tendon rupture can occur especially in nondisplaced distal radiua fractures

Answer 64

AOTA

Question 65

usual tx for forearm fractures

Answer 65

closed reduction

Question 66

WHAT IS THE MOST COMMON FRACTURE OF THE CARPAL BONE

Answer 66

scaphoid

Question 67

sequelae of missed scaphoid fracture

Answer 67

nonunion and avascular necrosis

Question 68

most common site of scaphoid fracture and higher incidence of avascular necrosis

Answer 68

proximal

Question 69

this clinical.finding suggesrs scaphoid fracture and should be considered as such until proven otherwise

Answer 69

pain in the anatomical snuff box

Question 70

the ff diagnostic test is helpful if no fracture is seen on xray a. MRI b. CT scan c. Utz

Answer 70

A

Question 71

true about pelvic fractures EXCEPT a. pelvic fractures are indicative of high energy trauma b. hemorrhage from pelvic trauma can be life threatening c. hemodynamic instability would require immediate open reduction and internal fixation d. ratio of blood ffp and platelets to be given in hemodynamically unstable px is 1:1:1

Answer 71

C. resucitation with fluids and blood

Question 72

Describe an open book.mechanism of pelvic injury

Answer 72

anteroposterior compression mechanism. pelvis springs open, hinged on the intact posterior ligaments with widening of the pubic symphysis

Question 73

initial.management for open book fracture of the pelvis

Answer 73

pelvic binder

Question 74

fractures of the sacrum may be difficult to see on xray. what could be done to visualize ?

Answer 74

CT scan

Question 75

compression of the nerve roots below the level of the spinal cord causing paralysis, impaired bladder and/or bowel control, loss of sexual sensation, and other problems. Even with immediate treatment, some patient may not recover complete function.

Answer 75

cauda equina syndrome

Question 76

indications for anterior plate and posterior fixation for pelvic fracture

Answer 76

pubic symphysis is widened 2.5 cm | posterior pelvic ligaments are also injured

Question 77

function of this nerve should be examined after acetabular fracture

Answer 77

sciatic nerve

Question 78

sequelae of hip dislocation not reduced immediately

Answer 78

avascular necrosis of femoral head

Question 79

45 degree views used to evaluate acetabular fracture

Answer 79

Judet views

Question 80

true about hip dislocations a. hip dislocations usually result from low impact trauma b. most commonly occur posteriorly c. acetabular fracture is rare d. closed reduction is usually unsuccessful

Answer 80

B a. high energy trauma c. common d. usually succwaaful

Question 81

What is a Pipkin fracture

Answer 81

femoral head fracture associated with hip dislocation

Question 82

true about hip fractures EXCEPT a. more common in women b. more common in of with osteoporosis c. Three most common fractures in the elderly are those of shoulder, spine and hip d. patients who suffer from hip fractures are at increased risk of DVT e. early ambulation diminishes risk for many of these adverse events

Answer 82

C. wrist, hip, spine (WHS)

Question 83

what is the treatment of choice for hip fractures

Answer 83

surgery within 24-48 hrs

Question 84

goals of surgery for hip fracture

Answer 84

minimize pain restore hip function allow early mobilization

Question 85

main blood supply for femoral neck

Answer 85

deep branches of the medial femoral circumflex arteries

Question 86

true about intertrochanteric hip fractures a. occur between the greater and lesser trochanter of the distal femur b. osteonecrosis is common c. reverse oblique intertrochanteric fracture exits on the medial cortex d. reverse oblique intertrochanteric fracture is best treated with a cephalomedullary nail e. dynamic hip screw is the right device to be used in reverse oblique fractures

Answer 86

D a. proximal femur b. uncommon c. lateral cortex e. wrong device

Question 87

true about subtrochanteric hip fractures EXCEPT a. usually at proximal shaft just distal to the lesser trochanter in an area of high biomechanical stresses b. tend to be significantly displaced c. most often treated with long cephalomedullary nail d. it could to bisphosphonate use

Answer 87

AOTA

Question 88

True of femoral shaft fractures EXCEPT a. associated with risk for complications such as thromboembolic events b. most commonly fixed with intermedullary nail c. Trauma patients who are hemodynamically unstable are treated immediately with open reduction d. NOTA

Answer 88

C. initially, they should have external fixation until the time they can undergo surgery. this is called damage control orthopedics

Question 89

coronal fractures thay usually involve the lateral femoral condyle

Answer 89

Hoffa fractures