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My2 MSK > trauma: lower limb > Flashcards

trauma: lower limb Flashcards

1
Q

what forms the pelvis

A

sacrum, ilium, ischium, pubic bones

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2
Q

what causes lateral compression pelvic hip fracture and what is damaged

A

one half pelvis crushed medially (RTA)

fractured ischium, pubic and sacral compression

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3
Q

what causes vertical compression pelvic hip fracture and what is damaged

A

fall and displaced superiorly, sacral nerve root and lumbosacral plexus at risk, one leg shorter

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4
Q

in anterioposterior compression pelvic hip fracture what is damaged

A

disrupts pubic symphysis –> opne book fracture, bleeding and tamponade

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5
Q

what is mainly at risk in pelvic fractures

A

usually high energy to resus, hypovolaemia, internal iliac and sacral venous plexus, bladder and urethra, lumbosacral plexus

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6
Q

who commonly gets hip fractures

A

elderly, osteoporosis, demal, co-morbidities –> increased falls

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7
Q

what co-morbidities can increase chances of falling

A

arrhythmias, postural hypotension

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8
Q

what is usually better treatment for hip surgery or conservative and why

A

surgery better as non-surgical longer recovery (pressure sores, atrophy, cant walk)

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9
Q

what can cause acetabulum fractures

A

posterior wall fractures (from femur eg knees on dashboard) and hip dislocation

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10
Q

what is best investigations for acetabulum intra articular fractures

A

CT > x ray

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11
Q

how do you manage acetabulum fractures

A

undisplaced (conservative), unstable (reduction and fixation), older (THR)

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12
Q

in an intra capsular hip fracture on head of femur what is often done

A

risk of AVN hemi-arthoplasty or THR

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13
Q

what is done for extracapsular head of femur hip fracture

A

should not cause AVN, compression/ dynamic hip screw

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14
Q

what can cause femoral shaft stress fractures

A

osteoporosis, metastatic disease, paget’s

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15
Q

what are risks of displaced femoral shaft fractures

A

blood loss, fat from medullar canal blocks venous system (embolism –> hypoxia or ARDS)

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16
Q

what is the initial management for a femoral shaft fractures

A

analgesia, femoral nerve block, THOMAS SPLINT

17
Q

what is the definitive management for a femoral shaft fractures

A

closed reduction and intramedullary nails

18
Q

how do you manage true knee dislocations

A

urgent reduced and revascularisation, unstable –> external fixator, multi-ligament reconstruction

19
Q

what might you consider in a grossly unstable knee joint

A

true knee dislocation with spontaneous reduction

20
Q

what are risks in high energy intra-articular proximal tibial fractures

A

neurvasculature and compartment synrome

21
Q

what imaging is useful in intra-articular proximal tibial fractures

A

CT

22
Q

how do you manage intra-articular proximal tibial fractures

A

ORIF, often need TKR in later life

23
Q

what is the most common cause of compartment syndrome from trauma

A

tibial shaft fracture

24
Q

how do you treat tibial shaft fractures non-operatively

A

knee cast if <50% displaced with frequent changes and X rays

25
Q

how do you treat tibial shaft fractures operatively

A

internal fixation

26
Q

how do you treat comminuted tibial shaft fractures

A

ORIF + plates and screws, intramedullary nailing, surgical grafts

27
Q

what symptom would warrant an ankle x ray

A

unable to bear weight

28
Q

what is commonly ruptured in ankle fractures

A

medial deltoid ligaments

29
Q

what are symptoms of medial deltoid ligaments rupture in ankle fracture

A

medial bruising and tenderness, talar shift (internally rotated)

30
Q

how do you treat stable ankle fractures

A

with no deltoid rupture - cast or splint

31
Q

how do you treat unstable ankle fractures

A

ruptured deltoid, ORIF

32
Q

what is a midfoot (lisfranc) fracture/ dislocation

A

uncommon fracture and dislocation at base of 2nd metatarsal

33
Q

what is gold standard for midfoot (lisfranc) fracture/ dislocation

A

CT

34
Q

what are symptoms of midfoot (lisfranc) fracture/ dislocation

A

grossly swollen, bruised, cant bear weight

35
Q

how is the base of the 5th metatarsal commonly fractured

A

inversion injury

36
Q

how do you manage 5th metatarsal fracture

A

walking cast/ boot

37
Q

how do you manage 1st metatarsal fracture

A

(uncommon), fixation

38
Q

how do you identify 2nd metatarsal fracture and how do you get it

A

stress fracture and bone scan

My2 MSK (29 decks)

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