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C. Year 3 MLA Muscoskeletal Conditions > Upper Limb Fractures > Flashcards

Upper Limb Fractures Flashcards

1
Q

A fracture, also referred to as a break, crack or hairline crack is a disruption in the continuity of the bone. Which of the following is NOT a type of fracture?

1 - transverse
2 - axial
3 - linear
4 - oblique misplaced
5 - oblique displaced
6 - spiral

A

2 - axial

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2
Q

What is an avulsion?

1 - tearing of a ligament where it attaches to the bone
2 - tearing of a tendon where it attaches to the bone
3 - part of bone breaks away attached to a ligament/tendon
4 - part of bone becomes calcified and tears tendon

A

3 - part of bone breaks away attached to a ligament/tendon

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3
Q

What is a pathological fracture?

1 - a fracture in a patient with comorbidities
2 - a fracture when someone is ill
3 - a fracture that would not have occured if the patient was well

A

3 - a fracture that would not have occured if the patient was well

  • suggest pathology of the bone
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4
Q

MSK There are 3 main types of joint injury. Which one of the following is NOT one of these?

1 - subluxed
2 - dislocated
3 - relined
4 - fracture with dislocation

A

3 - relined

  • subluxed means there is still some contact between the joint surfaces
  • dislocated means there is no contact between joints surfaces
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5
Q

When we describe the site of the bone injured, we typically use ALL of the following EXCEPT:

1 - metaphysis
2 - epiphysis
3 - marrow
4 - diapphysis

A

3 - marrow

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6
Q

When we talk about displacement or undisplaced, we must talk about:

  • direction
  • amount of
A

We must also talk about whether the joint is rotated or not

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7
Q

When we talk about angulated or non-angulated, we must talk about:

  • direction
  • angulation
A

We must also comment on if the fracture is open or not, i.e has it broken the skin

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8
Q

What is a comminution fracture?

1 - fracture of a bone in one place
2 - fracture of a bone in 2 places
3 - fracture of a bnone that breaks the skin

A

2 - fracture of a bone in 2 places

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9
Q

When a patient has a fracture, one of the key principles is to reduce movement. Although there are several reasons for this, what is the primary for the patient?

1 - increase recovery time
2 - reduce pain
3 - reduce risk of neuro damage
4 - reduce risk of PE

A

2 - reduce pain

  • the others are valid, but pain is key for patient care
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10
Q

The following are all used to treat soft tissue trauma:

  • Elevation
  • Monitor compartments (specific fractures)
  • Mobilise joints
  • Maintain muscle bulk
  • Physiotherapy
A
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11
Q

The following are all methods of conservative management of a fracture, EXCEPT which one?

1 - plaster of Paris
2 - removable splint
3 - brace
4 - removable pins on bone
5 - watch and wait

A

4 - removable pins on bone

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12
Q

Which 2 of the following are immediate general fracture complications?

1 - UTI
2 - PE
3 - cardiorespiratory
4 - fat embolism

A

3 - cardiorespiratory
4 - fat embolism

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13
Q

Which 2 of the following are immediate local fracture complications?

1 - bleeding/vascular comprimise
2 - nerve injury
3 - cardiorespiratory
4 - fat embolism

A

1 - bleeding/vascular comprimise
2 - nerve injury

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14
Q

All of the following are early general fracture complications:

  • PE (DVT)
  • Fat embolism
  • MI
  • CVA
  • Sepsis
  • UTI
A

All of the following are early local fracture complications:

  • Haematoma
  • Wound infection
  • Wound dehiscence
  • Implant issues – loss of reduction, dislocation
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15
Q

All of the following are late local fracture complications:

  • Delayed union, non-union, malunion
  • Avascular necrosis
  • Chronic infection
  • Implant failure
  • Secondary osteoarthritis
A
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16
Q

When considering a fracture, we have to be careful comparing adults with children. What extra part do we typically see in children that might look like a fracture, but is a growth plate?

1 - epiphysis
2 - metaphysis
3 - diaphysis
4 - physis

A

4 - physis

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17
Q

When considering adult vs paediatric bones, which has the higher cartilaginous component?

A
  • paediatrics
  • cartilage is what goes on to form bone
  • cortical bone is also more porous than adults
  • periosteum is thicker though
18
Q

Why must we be careful in fractures where the level of injury does not match the description in children?

1 - patient may be more severely injured than expected
2 - internal bleeding
3 - unknown pathology
4 - safeguarding issue

A

4 - safeguarding issue

  • parents/carer may be to blame for injury
19
Q

Why are growth plate fractures in children more important than fractures in adults?

1 - higher risk of bleeding
2 - higher risk of neuro damage
3 - risk of abnormal fgrowth
4 - risk of amputation

A

3 - risk of abnormal growth

20
Q

What is the name the the categories used to identify the type of fracture at the growth plates in a child?

1 - modified glasgow scale
2 - salter-harris scale
3 - CURB scale
4 - WELLS scale

A

2 - salter-harris scale

21
Q

What is a torus fracture in paediatrics?

1 - involves only one cortex of bone
2 - involves both cortices but one is still intact
3 - bone bends and is deformed like a plastic bone

A

1 - involves only one cortex of bone

  • cortex refers to the hard outer layer of bones
22
Q

What is a greenstick fracture in paediatrics?

1 - involves only one cortex of bone
2 - involves both cortices but one is still intact
3 - bone bends and is deformed like a plastic bone

A

2 - involves both cortices but one is still intact

23
Q

What is a plastic deformation fracture in paediatrics?

1 - involves only one cortex of bone
2 - involves both cortices but one is still intact
3 - bone bends and is deformed like a plastic bone

A

3 - bone bends and is deformed like a plastic bone

24
Q

What % of fractures in children <1 y/o are due to non-accidental injury?

1 - 5%
2 - 25%
3 - 50%
4 - 75%

A

3 - 50%

  • 2nd most common cause of death in children
25
Q

90% of fractures are due to abuse in children under what age?

1 - <1 y/o
2 - <5 y/o
3 - <10 y/o
4 - <15 y/o

A

2 - <5 y/o

  • if underreported there is a 30-50% change of further abuse
  • 5-10% change of death from abuse
26
Q

All of the following fractures can occur through non-accidental injury, but which is the most common?

1 - humerus
2 - tibia
3 - femur
4 - ribs

A

1 - humerus

27
Q

If we suspect a safeguasrding issue, who should we get involved in the care and management of a child?

1 - senior nurse on department
2 - crash team
3 - pediatric and safeguarding team
4 - consultant on call

A

3 - pediatric and safeguarding team

28
Q

Are upper of lower limb fractures more common?

A
  • upper limbs
  • distal radius and ulna are most common
29
Q

What are 2 of the most common causes of upper limb injury from the list below:

1 - fall on outstretched hand (FOOSH)
2 - impact trauma
3 - direct injury (punch)
4 - infection

A

1 - fall on outstretched hand (FOOSH)
3 - direct injury (punch)

30
Q

A clavicular fracture generally occurs when someone falls onto an outstretch hand or a fall from a bike and can be managed conservatively by putting their arm in a sling. However, all of the following are indication for surgery, EXCEPT which one?

1 - Neurovascular injury
2 - Penetration of skin
3 - Lateral third injury
4 - Floating shoulder
5 - Risk of pulmonary embolism

A

5 - Risk of pulmonary embolism

31
Q

What is the most common dislocation of the shoulder joint?

1 - posterior
2 - inferior
3 - superior
4 - anterior

A

4 - anterior

  • occurs when abducted arm is externally rotated
  • common reoccurence, especially un younger children
32
Q

When a patient has a shoulder dislocation, we must check which sensory nerve supply?

1 - median nerve
2 - ulnar nerve
3 - radial nerve
4 - axillary nerve

A

4 - axillary nerve

33
Q

Proximal fracture of the humerous are common in the elderly and can be caused by a fall on an outstretched hand (FOOSH). Are these operated on in both younger and elderly patients?

A
  • no
  • elderly are managed conservatively
  • younger patients may be operated on
34
Q

A colles fracture occurs most commonly following a fall onto an outstretched hand (FOOSH). What is a colles fracture?

1 - radius and ulna are fracture
2 - fracture of proximal radius with displacement and deformity
3 - fracture of distal radius with displacement and deformity
4 - fracture of distal ulna with displacement and deformity

A

3 - fracture of distal radius with displacement and deformity

  • resembles dinner fork deformity
  • generally treated with a cast or surgery depending on the severity
35
Q

A colles fracture is a fracture of the distal radius with obvious displacement and deformity that resembles a fork. It commonly occurs following a fall onto an outstretched hand (FOOSH). Which nerve function needs be checked with this type of fracture?

1 - radial nerve
2 - ulnar nerve
3 - median nerve
4 - axillary nerve

A

3 - median nerve

36
Q

A colles fracture is a fracture of the distal radius with obvious displacement and deformity that resembles a fork. It commonly occurs following a fall onto an outstretched hand (FOOSH). How is this commonly treated?

1 - open surgery or cast
2 - cast only regardless of damage
3 - surgery only
4 - analgesis and splint

A

1 - open surgery or cast

  • depends on severity
37
Q

Using the mnemonic below, what are the 8 carpal bones of the hand?

Some
Lovers
Try
Positions
That
They
Can’t
Handle

A

1 - Some – Scaphoid
2 - Lovers – Lunate
3 - Try – Triquetrum
4 - Positions – Pisiform
5 - That – Trapezium
6 - They – Trapezoid
7 - Can’t – Capitate
8 - Handle – Hamate

38
Q

What is the most frequently fractured bone in a fall onto an outstretched hand (FOOSH)?

1 - Scaphoid
2 - Lunate
3 - Triquetrum
4 - Pisiform

A

1 - Scaphoid

  • causes tenderness over the anatomical snuffbox
  • may be normal on X-ray, but CT may show it
39
Q

The Scaphoid bone is the most frequently fractured bone in a fall onto an outstretched hand (FOOSH). What is a significant risk of this type of fracture?

1 - further bones may become fractured
2 - increased risk of RA
3 - result in avascular necrosis
4 - abnormal remodelling

A

3 - result in avascular necrosis

  • if radial artery of branch is damaged it can cause avascular necrosis of proximal part of the scaphoid bone
40
Q

A boxers fracture is when there is a fracture in the hand due a punch being thrown. Which bone is typically fractured?

1 - 5 metacarpal neck
2 - 5 metacarpal head
3 - 1st metacarpal neck
4 - 3 metacarpal neck

A

1 - 5 metacarpal neck

C. Year 3 MLA Muscoskeletal Conditions (17 decks)

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