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Miller > trauma > Flashcards

trauma Flashcards

1
Q

SIRS criteria

A

HR > 90, WBC <4 or >12, RR >20 w/ PaCO2<32, T <36 or >38

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2
Q

antibiotics for GA III open fracture

A

cephalosporin and aminoglycoside (gent)

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3
Q

antibiotic added for heavily contaminated wound or farm wound

A

penicillin

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4
Q

antibiotics for freshwater wounds

A

fluoroquinolone (cipro or levo) or 3/4th generation cephalosporin (ceftazidime)

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5
Q

antibiotics for saltwater wounds

A

doxy and ceftazidime or a fluoroquinolone

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6
Q

flap and blood supply for middle third tibial wound

A

soleus flap, posterior tib artery

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7
Q

radiation dose for HO ppx

A

600-700 cGy 24 hours before up to 72 hours after surgery

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8
Q

main findings of LEAP study

A

absence of plantar sensation is not predictive of function, no difference in outcomes between limb salvage and amputation

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9
Q

operative indications for scapula fracture

A

angulation > 40 degrees, glenopolar angle < 20 degrees

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9
Q

Rockwood classification of AC injuries

A

1 - AC sprain, 2 - AC torn/CC sprain, 3 - AC and CC torn, 4 - clavicle through trap posteriorly, 5 - trap and deltoid detached (>100% displacement), 6 - clavicle beneath coracoid

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10
Q

operative indication for greater tuberosity. fracture

A

> 5 mm displacement

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11
Q

most common complication of periarticular locking plate for proximal humerus fracture

A

screw cutout

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12
Q

most reliable landmark. for judging humeral height

A

superior border of pec major insertion

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13
Q

acceptable alignment for non op treatment of humeral shaft fracture

A

<20 degrees anterior angulation, >30 degrees varus/valgus, <3 cm shortening

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14
Q

which nerves are at risk with distal interlocks in humeral nail?

A

radial nerve with lateral to medial, musculocutaneous with AP

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15
Q

first and last muscles to return in radial nerve injury

A

first - BR, ECRL. last - EPL and EIP

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16
Q

radial fracture at what distance from the articular surface is suggestive of DRUJ injury?

A

DRUJ unstable in 55% when radial fracture <7.5 cm from articular surface

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17
Q

most common cause of irreducible DRUJ

A

interposition of ECU tendon

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18
Q

factors most predictive of loss of reduction in distal radius fractures

A

radial shortening, dorsal comminution

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19
Q

APC 1

A

symphysis < 2.5 cm, anterior SI ligaments stretched

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20
Q

APC 2

A

symphysis > 2.5 cm, rupture of anterior SI ligaments, sacrotuberous, sacrospinous

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21
Q

APC 3

A

symphysis > 2.5 cm, rupture of anterior and posterior SI ligaments, sacrotuberous, and sacrospinous

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22
Q

LC classification

A

all have pubic rami fracture, 1 - sacral compression fracture. 2 - posterior iliac wing fracture. 3 - contralateral APC

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23
Q

main cause of death in LC injuries

A

brain injury

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24
Q

strongest pins for pelvic ex fix

A

AIIS > iliac wing, but iliac wing tolerated better

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25
Q

Denis classification

A

1 - lateral to foramen, 2 - involves foramen, 3 - medial to foramen

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26
Q

best view to see S1 foramen for SI screw placement

A

outlet

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27
Q

xray view to make sure anterior column screw doesn’t penetrate joint

A

obturator oblique

28
Q

simple acetabulum fractures

A

posterior wall, posterior column, anterior wall, anterior column, transverse

29
Q

associated acetabulum fractures

A

posterior wall posterior column, transverse posterior wall, T-type, anterior column posterior hemitransverse, associated both column

30
Q

approach that provides best access to quadrilateral surface

A

modified stoppa

31
Q

what is the corona mortis

A

vascular communication between external iliac and obturator artery system

32
Q

which approach to the tab has the highest rate of HO

A

extended iliofemoral

33
Q

what is the spur sign and what view is it seen on

A

obturator oblique, represents intact portion of iliac wing in associated both column

34
Q

ilioinguinal medial window

A

medial to external iliac artery and vein

35
Q

ilioinguinal middle window

A

between external iliac vessels and iliopsoas

36
Q

ilioinguinal lateral window

A

lateral to iliopsoas (iliopectineal fascia)

37
Q

pipkin classification

A

femoral head. 1 - below fovea, 2 - above fovea, 3 - +femoral neck fracture, 4 - +acetabular fracture

38
Q

garden classification

A

femoral neck. 1 - valgus impacted. 2 - complete, nondisplaced. 3 - complete, partially displaced. 4 - complete, displaced

39
Q

what factor correlates most with satisfactory clinical outcome in tibial plateau fractures

A

maintenance of mechanical axis

40
Q

what bone void filler used for plateaus has highest compressive strength

A

calcium phosphate cement

41
Q

what factor has the highest impact on need for amputation in tibial shaft fractures

A

severity of muscle injury

42
Q

which BMP is approved in acute tibial shaft fractures? nonunion?

A

BMP-2 in acute with IMN, BMP-7 in nonunion

43
Q

angulation common in proximal third tibia fractures

A

valgus and apex anterior

44
Q

starting point for tibial nail

A

medial border of lateral spine

45
Q

preferred treatment for midshaft tibial nonunions

A

reamed exchange nailing

46
Q

zone of physis damage in physeal fracture

A

zone of provisional calcification within zone of hypertrophy

47
Q

pediatric blood volume

A

75-80 ml/kg

48
Q

order of elbow ossification centers

A

CRI(M)TOE(L) - 1, 3, 5, 7, 9, 11

49
Q

xray view for lateral condyle

A

internal oblique

50
Q

bado classification

A

Monteggia. 1 - anterior. 2 - posterior. 3 - lateral. 4 - radial head fracture dislocation + proximal ulna fx

51
Q

acceptable angulation in peds distal radius fracture with >5 years growth remaining

A

30 degrees sagittal plane, 10-15 degrees coronal plane

52
Q

ASIS avulsion

A

sartorius

53
Q

AIIS avulsion

A

rectus

54
Q

iliac crest avulsion

A

abdominals and TFL

55
Q

delbet classification

A

peds fem neck. 1 - transphyseal (almost 100% risk AVN). 2 - transcervical. 3 - basicervical. 4 - IT (10-15% risk of AVN)

56
Q

Meyers and McKeever tibial spine fx classification

A

1 - nondisplaced. 2 - minimally displaced w/ intact posterior hinge. 3 - completely displaced. 4 - completely displaced and rotated

57
Q

tibial plateau and tubercle physis closure

A

posterior to anterior, medial to lateral, proximal to distal

58
Q

tillaux fracture

A

SH 3 avulsion of AITFL

59
Q

distal tibial physis order of closure

A

central -> anteromedial -> posteromedial -> lateral

60
Q

triplane fracture

A

SH 4. sagittal plane through epiphysis. axial plane through physis. coronal plane through metaphysis

61
Q

what is the ISS

A

sum of square of 3 highest AIS scores. correlates w/ morbidity, mortality, LOS

62
Q

what structure travels with the round ligament or spermatic cord through superficial inguinal ring

A

ilioinguinal nerve

63
Q

best imaging to view U-type sacral fracture

A

lateral of sacrum or sagittal reformatted CT

64
Q

border between medial and middle windows

A

iliopectineal fascia

65
Q

common nerve injured in hindfoot nail

A

lateral plantar nerve (numbness over lateral plantar midfoot)

66
Q

last muscle to recover with a peroneal nerve injury at fibular neck

A

EHL

67
Q
A

Miller (11 decks)

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