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Flashcards in Ortho Deck (55):
1

Closed Fracture

Skin over the fracture is intact

2

Open Fracture

Overflying skin is disrupted “open wound”
More likely to need debridement and IV abx

3

Nondisplaced fracture

Fracture fragments are in an anatomic alignment

4

Displaced

Fracture fragmentsare NOT in anatomical alignment

5

Angulated Fracture

Fracture fragments are malaligned at an angle
New angle is formed

6

Segmental Fracture

Fx with at least 2 fracture lines that together isolate a segment of bone
Total 3 pieces

7

Comminuted Fractures

Fx that results in two or more fragments

8

Transverse Fracture

Fracture line forms right angle with longitudinal axis

9

Oblique fracture

Angulated fracture line

10

Spiral fracture

Complete fracture resulting from rotational force
Fracture winds around the bone

11

Intra articular

Involving joint space
Slower to heal and more pain and discomfort

12

Extra articular

No involvement of joint space

13

Impacted Fractaure

Fracture in which one of the fragments is driven into another fragment

Hyperdense area on xray
Frequently seen in neck fractures

14

Impacted Fracture

Fracture i which one of the fragments is driven into another fragment (hyperdense area = bone over bone) frequently seen in neck fractures

15

Compression Fracture

Vertebral collapse; often seen in osteoporotic patients

16

Greenstick Fracture

One side broken; opposing side is bent
Common in children bc they have softer bones
maintain integrity on one side other side breaks open
if in adults = bone remodel problem

17

Occult

Fracture that does not appear on xray
if high clinical suspicion--> CT, MRI
ex: fat pads at elbow

18

Avulsion

Release portion of bone at location of tendon insertion
patella and pieces of finger common
the tendon rips of part of bone from other

19

Stable

Fracture that remains in alignment after reduction

20

Unstable

Fracture that is displaced after reduction
get ortho surgery consult asap

21

Important components of hx and PE

Mechanism of injury--> level of force
Look at joint above and below
is skin intact, swelling, deformity, angulation, redness, crepitus, ROM, pinpoint or generalized pain, neurovascular integrity

22

Fracture management

give form of pain control (NSAIDs if possible)

23

What does RICE stand for

Rest, Ice, Compression, Elevate

24

Difference between splint and cast

Splint holds arm in particular position but is 1/2 a cast
Cast wraps all the way around the affected limb

25

5 P's of Compartment Syndrome

Pain, Pressure, Paresthesias, Paresis/Paralysis, Pallor/Pulselessness

26

Compartment syndrome tx

1. Remove cast/splint
2. measure pressure (pressure change less than 30 do fasciotomy)
3. Fasciotomy (cuts open skin to allow for compartments to swell out, cover with wound vac)

27

Type 3 Salter Harris

Across and below epiphysis

28

Type 4 Salter Harris

Two or Through epiphysis

29

Tx for clavicle fracture

majority can be managed with brace +/- sling
after 5 weeks if not fixed--> refer for surgery

30

Tenting of skin over clavicle

consistent w/ angular end or disjointed fracture

31

Proximal Humerus Fracture presentation

pt keeps bone close to their own body and uses other hand to stabilize it and prevent pulling

32

What is Sargent's Patch

oval space over the distal portion of deltoid--> if numbness or tingling then there was axillary nerve damage dt proximal humerus fracture

33

Define hemiarthropy

Replace portion of joint

34

Tx for severe proximal humerus fracture

open reduction and internal fixation --> realign using plate and pins

35

Pt. presents with shortened upper extremity bc the biceps and triceps are pulling

Humeral shaft fracture

36

RF for humeral shaft fracture

osteoporosis, osteopenia (otherwise takes great deal of trauma to break)

37

Tx of humeral shaft fracture

can be done non-operatively in a full splint or cast for 8 weeks
otherwise surgery with pins and plates

38

Xray feature of radial head fracture

**fat pads

39

FOOSH injuries

Radial head fracture, Colles' fracture, Scaphoid fracture, ???

40

Radial head fracture presentation

edema, ecchymosis over elbow, tenderness over radial head

41

Colles' Fracture

Fracture of radius causing particular angulation of the wrist

42

Colles' Fracture tx

closed reduction and casting (below the elbow) and keep wrist somewhat flexed

43

Scaphoid Fracture presentation

Snuffbox pinpoint tenderness

44

Xray views for Scaphoid Fracture

Make fist and ulnar deviation (scaphoid view)

45

Danger of Scaphoid Fracture

Avascular necrosis (make sure pulses are intact when splinting)

46

Monteggia Fracture

Anterior dislocation of radial head and fracture of proximal 1/3 of ulna
commonly seen with hand trauma

47

Galeazzi Fracture

Rip through radial ulnar articulation leading to ulnar dislocation

48

Boxer's Fracture

Comminuted transverse fracture of metacarpal

49

Xrays for Boxer's Fracture

AP and oblique

50

MC type of metacarpal fracture

Boxer's Fracture

51

What defines a hip fracture

could be any fracture of proximal femur, femoral neck or anything in acetabulum and into pubic symphysis or rami

52

Two types of Hip Fractures

1. Young--> MVA mc mechanism; involves femur below or at the trochanters
2. Elderly--> typically osteopenia or porosis and typically fracture in pubic ramus is ischeum or acetabulum, femoral neck is also common but NOT trochanters

53

External rotation and limb length discrepancy is sensitive for______

hip fracture

54

Mechanism of Jones Fracture

Typically when changing directions--> movement of whole body while foot is planted. ankle pivots, inversion of ankle onto 5th metatarsal and breaks it

55

Jones Fracture Tx

prone to non-union so non-weight bearing cast for 6-8 weeks followed by weight bearing cast for 8 more weeks