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Musculoskeletal > Week 6 > Flashcards

Week 6 Flashcards

(49 cards)

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1
Q

Risk factors of hip fractures

A

Osteoporosis «««females
Smoking
Malnutrition
Excess alcohol
Neurological impairment
Impaired vision
Low BMI

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2
Q

Define extracapsular hip fracture

A

Outwith head and neck
Trochanteric

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3
Q

Avascular necrosis more common in which type of hip fracture?

A

Intracapsular

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4
Q

Types of extracapsular hip farcture

A

basicervical
intertrochanteric
reverse oblique
subtrochanteric

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5
Q

Exam findings for hip fracture

A

No weight bearing
Shortened and ext rotated (not always)

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6
Q

If hip is displaced on imaging, head not sitting above neck and incomplete Shenton’s line?

A

Intracapsular fracture

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7
Q

Treatment for intracapsular fracture

A

High func:
- displaced - THR
- undisplaced - CHR (comp/dyn hip screw)

Low func:
- hemiarthoplasty

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8
Q

Treatment for extracapsular fracture

A

Intertroch
- DHS/CHS screw

Subtroch:
- IM nail (lower down shaft)

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9
Q

Main complications of each type of hip fracture

A

Intracapsular
-Non-union 20%
-AVN 6-20%
Extracapsular
-Malunion (joins poorly)
-Non-union (doesn’t join)

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10
Q

Exam signs of fracture

A

Crepitus, Bruising, Swelling, Deformity, Bony tenderness

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11
Q

Assessment of neurovasc func in fracture exam?

A

Neurology- Testing peripheral nerves, not dermatomes
Vascular- pulses, cap refil, colour and warmth

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12
Q

Neuro screen of limbs involves which nerves?

A

Upper:
- radial
- median
- ulnar

Lower:
- SPN
- DPN
- tibial

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13
Q

Initial management of fracture

A

Analgesia
Imaging
Splintage (many types)
Traction

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14
Q

Immediate management of open frcature

A

Direct pressure if bleeding
Reduce dislocation
Remove macroscopic debris
Photograph & cover
Stabilise
Neurovascular status before & after reduction
AP and lateral xrays

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15
Q

Infection management in open fracture?

A

Broad spectrum antibiotic WITHIN 3 HOURS
- until wound closed
- e.g. IV co-amoxiclav

Tetanus vax

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16
Q

Describe compartment syndrome

A

Musc comp pressure>perfusion pressure
Results in ischaemia, lactic acidosis, necrosis & muscle/nerve/vessel death

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17
Q

Common sites of compartment syndrome

A

Calf (2-15% get CS following tibial shaft #)
Forearm / hand
Foot
Thigh / buttock

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18
Q

Who gets comp syndrome?

A

Tibial fractures , esp male 10-35 years
Open fractures
Forearm fractures
People who inject drugs
Comatose prolonged lying
Anticoagulation and trivial trauma
May not involve a fracture
Burns

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19
Q

Tibial fracture with pins and needles in leg likely to be injury of which nerve?

A

Deep peroneal

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20
Q

Clin pres of compartment syndrome

Study These Flashcards
A

4 Ps
- pain (disproportionate pain and on passive stretch)
- paraesthesia
- pallor
- pulselessness

21
Q

Treatment of compartment syndrome

Study These Flashcards
A

Emergency two incision four compartment fasciotomy

22
Q

Management of limb fractures

Study These Flashcards
A

Cast/Splints
K wires
Internal fixation with plates and screws
Internal fixation with intramedullary nails
External fixation

Goals:
- restore joint surface/alignment/length/rotation

23
Q

How are ankle fractures classified?

Study These Flashcards
A

Weber’s classification - ABC (bottom to top)

24
Q

How is management of ankle fractures assessed?

25
Con vs operative management of ankle fractures
Con: - cast/moonboot Op: - open reduction internal fixation (ORIF)
26
Which leg fracture has higher risk of compartment syndrome?
Tibial shaft fracture
27
Con vs operative management of tbial shaft fractures
Con: - above knee cast Op: - IM nail/ORIF
28
Common clin pres of tibial plateau fracture
Young person, high energy trauma Low energy osteoporotic elderly Pres with assoc NV and soft tissue injury and comp syndrome
29
How are tibial plateu fractures classified?
Schatzker classification (Type 1: con management w cast)
30
Operative man of tib plat fracture
ORIF ExFix Delayed TKR
31
Initial and operative management of femoral shaft fracture
Thomas' splint Operative: IM nail or ORIF with plates
32
Initial management of pelvic fracture
Pelvic binder
33
Common distal radius fractures
Colles, Smith's, Barton's
34
Operative management of wrist fracture
ORIF MUA and K-wires ExFix
35
Eponymous fracture patterns of forearm
Monteggia - ulnar shaft fracture with dislocation of radial head at elbow Galiazzi - radial shaft fracture with ulnar dislocation at wrist
36
What elbow muscle function can be affected with olecranon fracture?
Full extension -triceps tendon insertion affected
37
Conserative management of humeral shaft fracture
Humeral brace/U-slab cast
38
Early local comps of fracture
Comp syndrome Vasc injury/distal ischaemia Nerve injury Skin necrosis
39
Early systemic comps of fracture
Hypovolaemia Fat embolism ARDS SIRS Multi-organ dysfunction
40
Late local comps of fracture
Stiffness/loss of function/union issues/CRPS/AVN/osteomyelitis/PT arthritis/Volkmann's
41
Late systemic comps of fracture
DVT/PE
42
SImple NV exam for kids with upper limb fracture
Rock, paper, scissors
43
Common paeds fracture patterns
Buckle - comp force Greenstick - one cortex breaks/bends
44
Salter-Harris 1-5 classification
I - transversely through physis (separates epi from meta) II - transversely through physis but exits through meta (triang fragment) III - crosses physis and exits through epi at joint IV - extends upwards from joint line, through physis and out meta V - crash/comp injury to growth place
45
How are elbow fractures classified?
Gartland - I, IIa, IIb, III
46
Describe Gartland classifications
I - undisplaced (cons treatment) II - displaced posteriorly, intact post periost hinge (MUA w K-wires) III - displaced posteriorly, no post periost hinge (MUA w K-wires)
47
Define toddler fracture?
Undisplaced spiral fracture of tibia w no fibular fracture
48
Typical clin pres of SUFE
Obese adolescent child of Afro-Carib descent Inability to bear weight, groin pain Externally rotated hip
49
What does a positive lightbulb sign indicate?
Posterior shoulder dislocation e.g. electrocution

Musculoskeletal (8 decks)

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