Week 6

Question 1

MOI for pelvic injuries

Answer 1

Younger - high energy

Older - osteoporosis, low energy

Question 2

what is at risk with pelvic injuries

Answer 2

internal iliac arterial system
pre-sacral venous plexus
bladder and urethral injuries

Question 3

open fracture initial management

Answer 3

reduce displacement

Question 4

what is essential in pelvic injuries

Answer 4

PR exam

- presence of blood indicates rectal tear

Question 5

what type of hip injuries do the elderly getting

Answer 5

pubic rami fractures

displaced lateral compression injuries w/ sacral fracture or SI joint disruption

Question 6

common MOI for humeral neck fractures

Answer 6

low energy
osteoporotic bone
FOOSH

Question 7

most common pattern for humeral neck fractures

Answer 7

fracture of surgical neck

medial displacement of the humeral shaft

Question 8

Mx of humeral neck fracture

Answer 8

minimally displaced - conservatively w/ sling and rehab

displaced - internal fixation

Question 9

complications of humeral neck fracture

Answer 9

stiffness
chronic pain
failure of fixation

Question 10

what type of fractures usually require shoulder replacement

Answer 10

head splitting fractures

Question 11

what is a Bankart lesion

Answer 11

detachment of the anterior glenoid labrum and capsule

Question 12

what is a Hill-Sachs lesion

Answer 12

posterior humeral head impacts on the anterior glenoid causing an impaction fracture of the posterior head

Question 13

what is the principal sign of axillary nerve injury

Answer 13

loss of sensation in the regimental badge area

Question 14

what can be done to improve stability in people with ligamentous laxity

Answer 14

capsular shift

physio

Question 15

MOI of posterior shoulder dislocation

Answer 15

posterior force on the adducted and internally rotated arm

Question 16

Tx for posterior shoulder dislocation

Answer 16

closed reduction
period of immobilisation
physio

Question 17

MOI of ACJ injuries

Answer 17

fall onto the point of the shoulder

can be sprain/subluxed/dislocated

Question 18

Mx of ACJ injuries

Answer 18

conservative Mx - sling
physio for a few weeks

chronic pain - surgery

Question 19

up to what degree of angulation can be tolerated in humeral shaft fractures

Answer 19

30 degrees

Question 20

what is susceptible in humeral shaft fractures to damage and how would it manifest

Answer 20

radial nerve

wrist drop and loss of sensation in the first dorsal web space

Question 21

Tx of humeral shaft fractures

Answer 21

humeral brace - most common

internal fixation w/ nail,plate,screws

non-union - plating and bone grafting

Question 22

MOI for olecranon fractures

Answer 22

fall onto the point of the elbow with contraction of the triceps muscle

Question 23

Mx for olecranon fractures

Answer 23

ORIF to restore triceps functio

Question 24

what does a diaphysial fracture of both bones of the forearm require

Answer 24

ORIF with plates and screws

Anatomical reduction

Question 25

clinical signs of scaphoid fracture

Answer 25

FOOSH tenderness in the anatomic snuff box pain on compressing the thumb metacarpal

Question 26

Ix of suspected scaphoid fracture

Answer 26

X-ray: AP Lateral 2 oblique views

Question 27

nothing seen on x-ray, but scaphoid fracture is still suspected

Answer 27

normal not to see anything | x-ray done two weeks later

Question 28

Tx for scaphoid fracture

Answer 28

suspected but not seen on x-ray - splinted and further assessed 2 weeks later 'clinical scaphoid fracture' otherwise - 6-12 weeks plaster cast

Question 29

complications of scaphoid fracture

Answer 29

non-union | AVN of PROXIMAL pole

Question 30

penetrating hand injury on volar side risk injuring what

Answer 30

flexor tendons, digital nerves and digital arteries

Question 31

penetrating hand injury on dorsal side risk injuring what

Answer 31

extensor tendons

Question 32

complete or significant partial tendon injury Tx

Answer 32

surgical repair

Question 33

what causes mallet finger

Answer 33

avulsion of the extensor tendon from its insertion into the terminal phalanx and is caused by forced flexion of the extended DIPJ cannot extend at DIPJ

Question 34

Tx of mallet finger

Answer 34

mallet splint holding the DIPJ extended worn continuously for a minimum of 4 weeks.

Question 35

in stress fractures, what Ix is used after x-ray

Answer 35

Bone scan

Question 36

Tx of toe fractures

Answer 36

stout boot

Question 37

what type of toes fractures may benefit from reduction and fixation

Answer 37

Intra‐articular fractures of the base of the proximal phalanx of the hallux

Question 38

open toe fractures require what

Answer 38

stabilisation with wires

Question 39

how are toe dislocations treated

Answer 39

closed reduction | neighbour strapping or wiring

Question 40

why are children's bones more likely to bend than break like adults

Answer 40

have a thicker periosteum

Question 41

children's fractures heal slower than adults - true or false

Answer 41

false | healer quicker due to thicker periosteum with rich source of osteoblast

Question 42

why is a greater degree of angulation tolerated in children

Answer 42

have a greater potential to remodel as they grow | bones form along lines of stress and can correct angulation

Question 43

at what age do child fractures get treated as adult fractures

Answer 43

puberty | around 12-14

Question 44

what type of fractures in children could disturb growth

Answer 44

around the physis (growth plate) | can result in shortened limb or angular deformity

Question 45

how does the Salter-Harris progress

Answer 45

prognosis is poorer as the classification progresses

Question 46

what is the Salter-Harris classification

Answer 46

classification of physeal fractures

Question 47

what should be considered in femoral shaft fractures in children

Answer 47

NAI Also, femur is a common site for benign and malignant bone tumors and the fracture may be pathological with osteolysis and cortical thinning.