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Flashcards in Trauma Deck (34):
1

What position has the lowest effect on compartment syndrome of the lower extremity

30 deg of ankle plantarflexion

2

What percentage of femoral neck fractures are missed with ipsilateral shaft fracture

5% incidence
30% missed

need to use fine cut CT to find it

3

What is the most optimal inferior screw placement for femoral neck fractures

posterior and adjacent to the femoral neck

4

Where can you avoid injury to the femoral nerve for retrograde femoral nailing

A-P proximal to the LT

5

Calculation of ISS and MISS

square of the largest 3 numbers

6

compare medial to lateral subtalar dislocations

medial are more common
lateral are more likely to be open with fractures
medial are more likley to be stable

7

predictor of sacral fracture nonunion

vertical fracture pattern

8

what factor most likley increases mortality in head injury patients

intra-operative hypotension

9

risk of infection in calcaneus fractures

smoking
open
diabetes

10

what parameter in pilon fractures determines poor outcome and return to work

lower level of education

11

gull sign on obturator oblique

posterior wall

12

spur sign on obturator oblique

ABC

13

imaging require for percutaenous column screws

obturator oblique - joint penetration
inlet iliac oblique - position of screw in pubic ramus
inlet obturator oblique - position of screw in iliac table

14

how much saline should you inject to diagnose traumatic arthrotomy of the knee

155 mL

15

indications of pre-ganglionic injury

loss of paraspinal muscles on EMG
horners
positive histamine test
medially winged scapula

16

benefits of blocking screws

obtain and maintain reduction
increase construct stiffness
neutralize translation forces

17

appropriate tibial alignment

50% cortical apposition

18

incidence of vascular injury in knee dislocation

40%

19

leading cause of death in pelvic ring fracture

hemmorhage overall
head injury in lateral compression

20

factors associated with increased mortality in pelvic ring fractures

systolic BP 60 years
increased Injury Severity Score (ISS) or Revised Trauma Score (RTS)
need for transfusion > 4 units

21

risk of anterior S1 plating

L4/5 injury

22

fresh water wounds

cipro

23

salt water wounds

doxycycline or ceftazidime

24

normal syndesmosis widening

decreased tibiofibular overlap
normal >6 mm on AP view
normal >1 mm on mortise view
increased medial clear space
normal less than or equal to 4 mm
increased tibiofibular clear space
normal

25

most important factor with outcome following amputation or reconstruction

ability to return to work
no difference in treatment

26

factors associated with wound healing

albumin > 3.0 g/dL
ischemic index > .5
transcutaneous oxygen tension > 30 mm Hg
toe pressure > 40 mm Hg
ankle-brachial index (ABI) > 0.45
total lymphocyte count (TLC) > 1500/mm3

27

complications of scapulothoracic dissociation

flail extremity (50%) - requires ampuation
early amputation (20%)
death (10%)

28

air bag decreases the rate of

closed head injuries
facial fractures
thoracoabdominal injuries
need for extraction

29

indications of adequate resusitation

MAP > 60
HR 7.2
base deficit - normal -2 to +2
pusle pressure > 15

30

parameters to consider DCO

ISS >40 (without thoracic trauma)
ISS >20 with thoracic trauma
multiple injuries with severe pelvic/abdominal trauma and hemorrhagic shock
bilateral femoral fractures
pulmonary contusion noted on radiographs
hypothermia

31

when do fix DCO fractures

7-10 days for pelvic fractures
within 3 weeks for femur fractures
7-10 days for tibia fractures

32

predictors of good outcomes in acetabular fractures

increasing patient age
time from injury to surgery (>3 weeks)
intraoperative complications
femoral head bone or cartilage injury
fracture reduction > 1-2mm

33

risk factors for spousal abuse

younger age
shorter length of relationship
emotional abuse
psychological abuse, sexual abuse
drug dependency
alcohol dependency

34

the medial femoral circumflex is

medial to glut maximus