ortho summary Flashcards
how to describe an x-ray
- type of X-ray (AP, lateral etc.)
- what bone
- patient details
- “this is of adequate technical quality”
- the most prominant finding is __
- feaatures of the fracture (displacement, angulation, rotation, open/closed, shortened)
- other fractures/malignancy/density
- soft tissues: effusion, gas, dislocation
- 2 veiws, 2 joints, 2 occasions
ways of referring to places on a bone
fracture patterns
salter-harrris classifiication
colles fracture
dorsally angulated, extra-articular distal radius fracture
management of colles fracture
non operatiive: closed reduction and immobilisation for non-comminuted, extra articular fractures
operature: for unstable, intra artiicular, communinuted significant displacement or shortening
scaphoid fracture
tenderness in the anatomical snuffbox
tenderness on axial loading of thumb
cast or operate if instable, displaced, proximal or comminuted
shenton line
garden classification
for NOF fractures
pelvic fracturre
high mortality due to injury to intra-abdominal organs, major arteries and veins
all patients require exmination of rectum, perineum and genitalia, lower limb neuro and abdo exam on secondary survey
management of pelvic fracture
A-E assessment
pelvic stabilisation with pelvic binder
CT scan
fast for theatre then ICU
ankle fractures
use weber classifcation:
weber A
below syndesmosis, usually stable
a medial malleolus fracture may be present
weber B
at level of syndesmosis, may be stable or unstable depending if the deltoid ligament rupture or medial malleolus fracture
weber C
proximal to syndesmosis, unstable, usually associated wit deltoid ligament or medial malleolus fracture
associated withh higher fibula fracturres
which weber class is unstable
weber C
which weber class is stable
weber A
management of non operatuve ankle fracture
weber A and some weber B
splint cast
CAM boot
management of operative ankle fracture
weber C, weber B is there is talar shift, open fractures
ORIF or external fixation
ORIF
open reduction and internal fixation
talar shift
when requesting ankle pathology ask for ‘mortise’ view’
to assess for talar shift
talar shift indicated instability of the joint
perthes disease
blood supply to the head of the thigh bone is disrupted
occurs in aged 4-10
short child with knee, thigh and groin pain and a limp
may also sow thing/calf atrophy and shortening of the leg
developmental dysplasia of the hip
at birth
identified by barlow and ortolani’s signs
treated with harness, abduction splint or open/closed reduction
slipped capital femoral epiphysis
9-13 years
overweight male teenager
knee, thigh, groin pain and limp
treated with surgical pinning
