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Ortho-Rheum > Orthopaedic Trauma Day 3 > Flashcards

Orthopaedic Trauma Day 3 Flashcards

(84 cards)

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1
Q

what metacarpal bone has the highest tolerance for fractures and which has the lowest tolerance?

A

highest tolerance = thumb
lowest tolerance = small finger

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2
Q

what is the most common metacarpal fracture?

A

5th metacarpal bone fracture (little finger)

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3
Q

defined as a small finger metacarpal neck fracture

A

boxer’s fracture

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4
Q

what should we evaluate if a patient has a possible boxer’s fracture?

A

rotation/scissoring

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5
Q

what is the non-op treatment for a 5th metacarpal fracture/boxer’s fracture? (2)

A

closed reduction
ulnar gutter splint

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6
Q

what is the operative treatment for a 5th metacarpal bone fracture/boxer’s fracture?

A

open reduction internal fixation (ORIF)

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7
Q

when would we want to operate on a 5th metacarpal bone fracture? (4)

A

open
intra-articular
rotational deformity
>60 deg of angulation

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8
Q

identify fracture

A

boxer’s fracture (neck)

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9
Q

identify

A

5th metacarpal bone fracture with volar angulation

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10
Q

identify

A

5th metacarpal shaft fracture with volar displacement

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11
Q

what are the most common phalanx fractures?

A

distal phalanx

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12
Q

what are the least common phalanx fractures?

A

proximal phalanx

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13
Q

a phalanx fracture most commonly occurs in which finger?

A

small finger

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14
Q

where do most distal phalanx fractures occur?

A

tuft of phalanx

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15
Q

distal phalanx fractures are most often associated with what?

A

nail bed/matrix laceration

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16
Q

very common injury in which nailbed can be either crushed, lacerated, or amputated

A

tuft fracture

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17
Q

identify

A

tuft fracture

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18
Q

identify

A

shaft fracture of distal phalanx

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19
Q

identify

A

volar base fracture

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20
Q

identify

A

dorsal base fracture

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21
Q

how should base fractures be treated?

A

by hand surgeon

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22
Q

which fractures of the phalanx often have dorsal or volar displacement d/t insertion of FDS and FDP tendons, as well as shortening and rotation of finger; typically requires surgical fixation?

A

middle and proximal phalanx fractures

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23
Q

what is the typical treatment for middle and proximal phalanx fractures?

A

surgery

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24
Q

what non-op management can be used for middle and proximal phalanx fractures? (2) when can we use this treatment? (2)

A

buddy tape or finger splint

no head or base involvement
no rotation or displacement

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25
identify
proximal phalanx shaft fracture
26
identify
proximal phalanx fracture of ring finger
27
identify
tuft fracture to ring finger
28
what 2 locations do elderly patients most commonly have hip fractures?
femoral neck intertrochanteric
29
what 2 locations do young patients most commonly have hip fractures?
acetabulum proximal femur
30
which hip fracture is typically associated with hip dislocations?
femoral head fractures
31
which 2 hip fractures have a high risk of avascular necrosis (AVN)?
femoral head fracture femoral neck fracture
32
what imaging is required for further evaluation of femoral head fracture?
CT
33
non-op vs operative treatment of femoral head fractures depends on what? (2)
location fracture displacement
34
identify
femoral head fracture
35
hip fracture in which leg is shortened and externally rotated with abduction
femoral neck fracture
36
what should be ordered since femoral neck fractures are difficult to discern on plain film xray and CT?
MRI d/t possible occult fracture
37
what are femoral neck fractures highly associated with?
high morbidity and mortality
38
what are the treatment options for femoral neck fractures? (3)
*surgery* ORIF hip hemiarthroplasty total hip arthroplasty
39
identify
femoral neck fracture
40
identify
impacted femoral neck fracture
41
proximal femur fracture at level of the greater and lesser trochanters in which the leg is shortened and externally rotated
intertrochanteric fractures
42
what is the treatment for intertrochanteric fractures?
cephalomedullary nail fixation
43
identify
intertrochanteric fracture
44
result in femoral head dislocations from the acetabulum socket
hip dislocations
45
which nerve is most commonly injured in hip dislocations?
sciatic nerve
46
are most hip dislocations anterior or posterior?
posterior
47
why is it important to reduce a hip dislocation as soon as possible (within 12 hours)?
prevent AVN of femoral head
48
what is the treatment for a hip dislocation?
reduction by flexing knee and hip and pulling superiorly with countertraction
49
a patient's physical exam shows their leg is adducted with internal rotation. what injury is likely?
hip dislocation
50
identify
posterior hip dislocation
51
identify
anterior hip dislocation
52
in which patients is femur shaft fracture most common in?
young patient
53
what is likely to occur in a femur shaft fracture?
high blood loss
54
what are 4 complications of a femur shaft fracture?
fat emboli internal soft tissue damage frequent nonunion leg length discrepancy
55
what is the treatment for a femur shaft fracture?
intermedullary nail within 24 hrs
56
identify
comminuted femur shaft fracture
57
identify
spiral femur shaft fracture
58
in which 2 fractures is skeletal traction used?
femur fractures acetabulum fractures
59
what are the 2 most common locations for a skeletal traction?
distal femur proximal tibia
60
why do we use skeletal traction? (4)
reduce pain minimize blood loss soft tissue rest decrease muscle contraction
61
intra-articular fracture of the proximal tibia
tibial plateau fracture
62
what leads to joint impaction of a tibial plateau fracture?
axial load injury
63
what diagnostic should be used for a tibial plateau fracture?
CT
64
what nerve is most commonly injured in tibial plateau fractures?
common fibular nerve
65
what are 4 complications that a tibial plateau fracture can be associated with?
meniscal tear ACL injury compartment syndrome neurovascular injury
66
what are 2 treatment options for a tibial plateau fracture?
acute ORIF temporary external fixator + ORIF later
67
what are the post-op rules for a tibial plateau fracture?
weight bearing restricted for 12 weeks for healing
68
identify
tibial plateau fracture + fibular head fracture
69
identify
tibial plateau fracture
70
what imaging is best for patella fractures?
lateral knee xray
71
what does a patella fracture lead to?
loss of extensor mechanism
72
what part of the physical exam determines if a patient with a patella fracture needs surgery or not?
extensor mechanism
73
what are the 2 non-op treatments for a patellar fracture since extensor mechanism is intact?
knee immobilizer hinged knee brace locked in extension *WBAT*
74
what are the 2 op treatments for a patellar fracture since extensor mechanism is not intact?
ORIF with k-wires or screws + tension suture plate/screws
75
what is the most common patellar fracture?
transverse
76
identify
transverse patellar fracture
77
what is the most common knee dislocation? anterior or posterior?
anterior
78
why will knee dislocation xrays look normal and are easily missed?
half of them spontaneously reduce
79
what nerve and artery are most at risk in knee dislocations?
common peroneal nerve popliteal artery
80
what is the treatment for a knee dislocation? (3)
immediate reduction + stabilization ankle-brachial index + CT angio external fixator
81
identify
posterior knee dislocation
82
what type of knee dislocation has a higher risk for vascular injury? (popliteal artery)
posterior knee dislocation
83
identify
anterior knee dislocation
84
what type of knee dislocation has a higher risk for nerve injury? (common peroneal nerve)
anterior knee dislocation

Ortho-Rheum (27 decks)

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