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Ortho Trauma Flashcards

(55 cards)

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1
Q

Anterior dislocation of shoulder may cause damage to which nerve?

A

axillary

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2
Q

What is the probable injury if can’t initiate abduction of shoulder?

A

Rotator cuff tear

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3
Q

What is the probable injury if wasting of deltoid?

A

axillary nerve paralysis

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4
Q

What is the probable injury if loss of deltoid contour?

A

Anterior shoulder dislocation

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5
Q

What is the probable injury if prominence of distal clavicle?

A

Acromio-clavicular dislocation

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6
Q

Name 5 hard signs vascular injury

A 
• Active pulsatile bleeding
• expanding pulsatile haematoma
. Shock with ongoing bleeding
• absent pulses or pulse deficit
• bruits/thrills over injured areas
Ischaemia
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7
Q

Name 5 soft signs vascular injury

A 
• History severe bleed
. Associated multiple fractures and soft tissue injury
• non expanding haematoma
• unexplained hypotension
• anatomical related structure injury
Associated nerve injury
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8
Q

Describe the Gustilo and Anderson classification of open fractures (5)

A

• Type 1: low energy, minimal soft tissue damage, wound <1 cm
• type 2: higher injury, laceration >1 cm, minimal contamination
• type 3 a: high energy, adequate soft tissue cover
• 3b: high energy, extensive soft tissue stripping, inadequate cover, massive contamination
Type 3 c: vascular injury requiring repair

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9
Q

Injury to radial nerve as in a humeral shaft fracture will result in what motorfollout?

A

Inability to extend and abduct thumb

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10
Q

Most Common type shoulder dislocation?

A

Anterior

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11
Q

Describe Colles fracture location, mechanism, risk groups, presentation, treatment.

A

ColleD
• Distal radius
• fall on outstretcheD hand while Dorsally flexed
• elDerly (osteoporosis)
• Dorsally displaced, Dorsally angulated, Dinner fork deformity, tender Distal forearm
• closeD reduction and cast

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12
Q

Treatment tibial plateau fractures?

A

ORIF

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13
Q

How can compartment syndrome be prevented?

A

Monovalent antiserum

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14
Q

Name 3 indications primary amputation

A
  • dead leg
  • 2 or more dead compartments infrapopliteal
  • mangled limb
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15
Q

Which antibiotic give for type 1 and 2 Gustilo Anderson open fracture?

A

Kefzol (cefazolin) or augmentin (co-amoxiclav)

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16
Q

Which antibiotic give for type 3 Gustilo Anderson open fracture?

A

Kefzol/augmentin plus gentamicin (clindanycin if penicillin allergy)

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17
Q

Which antibiotic give for rail track or farmyard injury?

A

Kefzol or augmenton and gentamicin and flagyl

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18
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 1 open fracture

A
  • low energy
  • <1cm
  • low soft tissue injury
  • no contamination
  • No comminution, simple pattern
  • soft tissue coverage
  • no vascular injury
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19
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 2 open fracture

A 
• moderate energy
• >1 cm
. Moderate soft tissue injury
• low contamination
• some comminution or simple fracture pattern
• soft tissue coverage
• no vascular injury
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20
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3a open fracture

A
  • High
  • > 10 cm
  • extensive
  • severe
  • severe/complex
  • yes
  • No
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21
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3b open fracture

A
  • high
  • > 10 cm
  • extensive
  • variable
  • severe/complex
  • no, require reconstruction
  • No
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22
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3c open fracture

A 
• High
• >10 cm
• extensive
• variable
• severe/complex
Variable
• yes, require reparation. Limb threatening
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23
Q

What constitutes unstable pelvic fracture?

Study These Flashcards
A

Fractures that involve ring

24
Q

Tile classification of pelvic fractures? (3)

Study These Flashcards
A

Type A: stable
Type B: rotationally unstable, vertically stable. Eg open book (ap compression) and lateral compression injuries
Type c: vertically and rotationally unstable.

25
Name 2 signs urethral injury and investigation to confirm
• Blood urethral meatus . High riding or floating prostate Retrograde urethrogram
26
Name 2 indications cystogram
* Gross or substantial haematuria > 25 RBC / hpf | * hematoma and or free fluid in pelvis
27
How test pelvic stability?
Gentle pressure on iliac wings. Only do once.
28
How is pelvic binder/sheet tied?
• At level greater trochanters | . Strap legs in internal rotation, knees 30 degrees flexion
29
Most Common type hip dislocation?
Posterior
30
Attitude of limb with post hip dislocation? (5)
* Short * adducted * internally rotated * flexed hip * flexed knee
31
Attitude of limb with ant hip dislocation? (3)
* leg externally rotated * abducted * hip slightly flexed
32
Treatment salter Harris 1 and 2?
Closed reduction and POP
33
Treatment salter Harris 3 and 4?
Surgery
34
Most common fracture around elbow?
Supracondylar
35
Sign on xray of supracondylar fracture?
Flag or fat pad sign
36
Untreated supracondylar fractures may result in which deformity?
Gunstock
37
What is Waddell's triad?
• femur fracture • Head injury . Thoracic or abdominal injury Present until otherwise proven
38
In which children can gallows traction be used for femur fractures?
* <12kg | * <2y
39
In which children can pavlik harness be used for femur fractures?
<3 months age
40
Most common salter Harris injury?
Type 2
41
Which 3 clavicle fractures are not treated conservatively?
* Lateral 1/3 * open * nv injury
42
Garden hip injury classification?
Garden undisplaced: Shenton line intact but can see fracture | Garden displaced: disrupted shenton
43
Treatment of garden undisplaced fracture in > 65 y?
In situ pinning (no reduction)
44
Treatment of garden displaced fracture in > 65 y?
Community walker, active: total hip replacement | Home shuffler, frail: hemi-arthroplasty. Only replace femur head, not acetabulum
45
Complication of deep penetrating injury of muscle mass?
Gas gangrene
46
Anterior dislocation of shoulder may cause damage to which major structure most likely and most importantly?
Axillary nerve
47
Name the 2 clinical features of viable muscles
* capacity to bleed | * contractility
48
Which important structure is commonly injured in post hip dislocation?
Sciatic nerve
49
What type of splint is used for adults with midshaft femur fracture
Thomas splint. May be used with either skin or skeletal traction. Should have groin ring circumference 3cm more than normal thigh circumference.
50
Most important complication of intra- articular fracture?
Early onset rheumatoid arthritis
51
Clinical presentation of posterior shoulder dislocation? (2)
* Inability to abduct | * restriction external rotation
52
How long wear posterior splint after elbow dislocation?
2 weeks
53
Which side of tibial plateau is more commonly fractured?
Lateral
54
Which traction device is used for supracondylar humerus fractures in children?
Dunlop traction
55
How long should pressure garments be worn? For burns
1 year

Trauma (21 decks)

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