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othopaedics > specific fractures > Flashcards

specific fractures Flashcards

1
Q

5 main hip # classification based on treatment

A

-intracapsular undisplaced= cannulated hip screw
-intracapsular displaced young=cannulated hip screw
-intracapsular displaced old>80=hemiarthroplasty
-intracapsular displaced old<80=THR depending
-extracapsular intertrochanteric=dynamic hip screw
=subtrochanteric=intra-medullary nailing

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2
Q

arteries of the femoral head

A
  • medial circumflex
  • lateral circumflex
  • ascending transverse arc
  • retinacular arteries
  • artery of ligamentum teres
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3
Q

fractures most associated to osteoporosis and elderly

A

femoral head
humeral head
vertebrae
colles wrist

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4
Q

what are neck of femur fractures at risk of and why

A

-AVN

due to blood supply all comes from below except small amount ligamentum teres

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5
Q

cause of subtrochanteric fractures

A

pathological or high energy trauma

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6
Q

assessment of nof fracture

A
  • inability to weight bear
  • shortened and externally rotated leg
  • co-morbidities
  • pain
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7
Q

x-rays for hip fracture

A

AP pelvis and lateral

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8
Q

femoral shaft fracture cause, management and risk

A
  • high energy trauma
  • IM nailing or
  • risk of fat embolism and ARDS
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9
Q

splint used for femoral fractures

A

thomas splint

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10
Q

wrist fractures classification based on treatment

A
  • posterior dorsal angualted=MUA and cast

- anterior volar angulated will slip in cast so use ORIF

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11
Q

what is a colles fracture

A 
FOOSH
dorsal angulated
displaced
distal radius
-shortened and bayonetting can be
low energy in elderly
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12
Q

complications of wrist fractures

A
  • median nerve compression
  • mal union
  • carpal tunnel syndrome
  • can get impingement of ulna
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13
Q

management dru # in children

A

closed reduction in plaster or internal fixation with percutaneous k wires

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14
Q

surgery for wrist fracture

A

-plates and screws
distal radius locking plates
can be done under brachial plexus block

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15
Q

what is a smith fracture and treatment

A

volar displaced ankle fracture

volar buttress plate

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16
Q

weber classification

A

-A distal to syndesmosis
B=at level of syndesmosis
C=proximal to syndesmosis
fracture of fibula

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17
Q

which weber has greater risk of talar shift and instability and needs orif

A

weber c

sometimes B

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18
Q

what other factor in ankle fracture determines treatment

A

bi or uni-malleolus
uni can do conservative probably
-bi usually weber c so orif and risk of talar shift

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19
Q

what is a proximal humerus # associated too

A
  • ostop

- elderly women FOOSH

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20
Q

management of proximal humerus #

A

-non-op in elderly
use a sling
-orif sometimes in young depending if comminuted

21
Q

complications of proximal humerus #

A
  • NV
  • stiffness
  • non union
  • 2ndary arthritis
  • AVN
22
Q

humeral # shaft mangement

A
  • heals well due to blood supply

- immobilise in U slab or functional brace 8-12 weeks

23
Q

nerve commonly trapped at elbow

A

ulna

24
Q

distal humerus # 4 types

A

unicondylar
bicondylar
supracondylar
intercondylar

25
Q

most common distal humerus #

A

intercondylar as fall drives coronoid into trochlea so split condyles apart

26
Q

complications of distal humerus #

A

ulna nerve

  • heterotopic ossification
  • arthritis
  • stiffness
27
Q

most common distal humerus # in children

A

supracondylar due to FOOSH as force transmits up forearm to metaphysis

28
Q

forearm fractures are common in

A

children

29
Q

treatment for forearm fracture

A

plate or cast in children

30
Q

complication of forearm fracture

A
  • mal union
  • damage to all 3 nerves
  • cross union between forearm bones
  • compartment syndrome
31
Q

what is a galeazzi #

A

radius shaft # with dislocation of DRUJ

32
Q

what is a monteggia #

A

displaced ulna # assoc. to radial head dislocation

33
Q

what is the most commonly # carpal bone

A

scaphoid bone

34
Q

what causes a scaphoid # and who most commonly

A

violent hyperextension of the wrist-fall

seen most commonly in young males

35
Q

why is the scaphoid at risk of AVN

A

blood arises from distal end so gets disrupted

36
Q

most common part of the scaphoid to fracture

A

80% in mid part

37
Q

symptoms of a scaphoid fracture

A
  • pain in anatomical snuff box
  • weakness of pinch grip
  • pain axial compression of the thumb
38
Q

x-ray views of the scaphoid

A

AP
lateral and oblique x2
as easy to miss

39
Q

management of a scaphoid#

A
  • cast if absent clinical signs and inx and repeat view in 2 weeks
  • cast for 6-8 weeks if minimmaly displaced or undis
  • for displacement >1mm then ORIF
40
Q

pelvic ring fracture complications

A

retroperitoneal and abdo haemorrhage risk

41
Q

management of pelvic ring #

A

-ATLS
resuscitation
AP for radiograph
pelvic cast

42
Q

what is the most common cause for compartment syndrome

A

tibia shaft #

43
Q

what are tibia plateau # associated too

A

meniscal tears
collateral/ cruciate rupture
NV and compartment syndrome

44
Q

management of tibia shaft #

A
  • cast if closed

- if open need debridement and IM nailing or ex fix

45
Q

name for distal tibia # from a heigh

A

pilon #

46
Q

3 areas on a 5th metatarsal #

prox to distal

A
  • avulsion #
  • Jones #either stress or acute break
  • proximal diaphyseal #
47
Q

management of Jones #

A

risk of watershed injury due to blood supply so may need ORIF

48
Q

OTTAWA rules for deciding whether to x-ray an ankle

A

 If ankle pain is present and there is tenderness over the posterior lateral malleolus 6cm
 If midfoot pain is present and there is tenderness over the navicular or the base of the 5th metatarsal then x-ray foot
 If there is ankle or midfoot pain and the patient is unable to take 4 steps

othopaedics (21 decks)

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