Trauma Flashcards

1
Q

Pneumonic for Pathological fractures?

A

Osteoporosis
Metabolic - hyperPTH, HyperT, rickets, osteogenesis imperfecta
Infection/Iatrogenic - radiation, surgical defect
Tumour

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2
Q

Rule of 2s for imaging?

A

2 sides
2 views
2 joints
2 times before and after reduction

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3
Q

Garden classification of Hip NOF?

A

Undisplaced, incomplete fracture
Undisplaced, complete fracture
Incompletely displaced, complete fracture
Completely displaced, complete fracture

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4
Q

Weber’s classification for ankle fracture?

A

A = Fracture below level of syndesmosis
B = Fracture at level of syndesmosis
C = Fracture above level of syndesmosis

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5
Q

Early local complications of fractures?

A

Neurovascular injury
Compartment syndrome
Soft tissue blister -> infection

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6
Q

Late local complications of fractures?

A

Malunion, Nonunion, delayed union
AVN, post-traumatic arthritis and stiffness
OM
Heterotrophic ossification
Joint instability
Nerve compression/entrapment
Reflex sympathetic dystrophy

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7
Q

Early systemic complications of fractures?

A

Fat embolism, DVT/PE
ARDS
Haemorrhagic shock

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8
Q

Operative treatment of indirect fracture healing?

A

Intramedullary nailing
Bridge plating

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9
Q

Operative treatment for direct fracture healing?

A

Lag screw, compression plates

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10
Q

External stabilization for fracture?

A

Slings in UL, Splint, cast, traction in femur, external fixator

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11
Q

Internal stabilization for fracture?

A

Perc pinning
Extramedullary or intramedullary fixation

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12
Q

Examples of fragility fractures? They are often low-mechanism fractures

A

Vertebral compression
Hip fractures
Proximal humerus
Distal radius
Sacral fractures

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13
Q

Rule of 11s for distal radius fracture?

A

Radial height 11mm
Volar tilt 11 degrees
Radial inclination 22 degrees
More means will recommend surgery

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14
Q

Internal vs external fixation?

A

External fixation means outside skin e.g. rods/pins

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15
Q

5 ligaments for syndesmotic injury?

A

AITFL
PITFL
Interosseous membrane
Interosseous ligament
Inferior transverse ligament

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16
Q

What is stable vertebral fracture and its features?

A

Structural ability of spine is compromised
1. Spine can move as multiple independent units, which can cause spinal cord injury
2. Mid-column and posterior column features

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17
Q

What sling for humerus fracture?

A

Collar and cuff sling

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18
Q

What sling for clavicle fracture?

A

Arm sling

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19
Q

What fixture to put right and a while after fracture?

A

Back slab to give space to swell and prevent compartment syndrome

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20
Q

what fixture is put a while after fracture?

A

Cast - circumferental tc.

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21
Q

Where to use splint/brace or other fixtures?

A

Splint for smaller joint fractures
For bigger joints use brace e.g. knee
Can use aircast boot for feet

22
Q

During long-term healing of clavicle fracture there can be a _________

A

Can have slight bony bump over clavicle. But its normal.
Some pts can feel shoulder is sagging or narrower, but its fine.

23
Q

When u walk with a healing ankle fracture it will 100% ____.

A

It will definitely swell. But its fine

24
Q

Humerus or femur fracture can have _____ fractures within the head. Seen in trauma clinic

A

3 segmental fracture

25
Q

Always look for ______ deformity as they predispose to functional problems. For hand!

A

Always look for ROTATIONAL deformity as they predispose to functional problems. Mild deformities are generally tolerated

26
Q

Borders of the 3 Gilula lines in AP view of hand?

A

Arc 1: proximal surface of proximal carpal row
Arc 2: Distal surface of proximal carpal row
3: Proximal surface of capitate and hamate

27
Q

What is position of “safety’ in hand fractures? For conservative Mx in unsure situations

A

Wrist extended 20°, MCP flexed 90°, DIPJ and PIPJ fully extended

28
Q

Differentials of radial wrist pain?

A

Scaphoid fracture
Distal radius fracture
1st CMCJ fracture/dislocation
Sprain/contusion

29
Q

Clinical presentation of scaphoid fracture

A

Snuffbox tenderness
Tuberosity tenderness - volar forearm
Resisted pronation
Axial grind

30
Q

_____% of scaphoid bone fractures are initially undetectable on XR

A

25%!!!

31
Q

Best initial test for scaphoid fracture

A

Wrist XR in PA, Lateral, oblique, and possibly scaphoid view.

32
Q

Where do eschars occur?

A

On full thickness injuries - wounds that extend below epidermis and dermis

33
Q

Complications of scaphoid fracture

A

Carpal tunnel syndrome
Avascular necrosis - Scaphoid Nonunion Advanced Collapse

34
Q

What sign for Lunate dislocation?

A

Spilled tea-cup sign. Lunate does not articulate with radius

35
Q

What is seen for perilunate dislocation?

A

Capitate does not articulate with lunate and radius

36
Q

Mechanism of mallet fracture of finger?

A

Stubbed finger! Volleyball, Basketball, falls

37
Q

Seddon’s classification of nerve injury?

A

Neuropraxia -> Axonotmesis -> Neurotmesis

Neuropraxia = minor injury
Axonotmesis = Nerves stretch + damaged
Neurotmesis = severed

38
Q

What is Maisonneuve fracture?

A

Spiral fracture of upper third of fibula

likely Weber C

39
Q

Criteria for stable / unstable acute spine fractures?

A

Number of affected columns!
1 = stable
2 or more = unstable
Disruption of post ligamentous complex = chronic unstable

40
Q

Why is scaphoid prone to AVN?

A

Scaphoid is under a lot of stress from motion of carpal bones
Scaphoid is unattached to any muscle -> poorer blood supply

Scaphoid supplied by dorsal carpal branch of Radial artery

41
Q

What bones are prone to AVN? Why?

A

Talus
NOF
Scaphoid

Talus and Scaphoid are watershed zones.

42
Q

Why is NOF prone to AVN? Compare to intertrochanteric #

What supplies NOF?

A

NOF is site of anastomoses of medial and lateral circumflex arteries that branch from Profunda femoris.
IT # does not disrupt any blood supply.

43
Q

What does lunate/perilunate dislocation show on XR?

A

AP view = Assess Gilula lines - carpal alignment shows more overlap btw lunate and capitate
Lat view = line of radius-lunate-capitate [apple on cup shape]

Scaphoid view if want to TRO scaphoid #

44
Q

What is Volkmann’s ischemic contracture?

A

Fibrotic contracture of skeletal muscle weeks of months after severe ischemic insult of compartment syndrome

45
Q

How good is healing potential of NOF frac? Why?

A
  • Femoral neck is intracapsular, bathed in synovial fluid.
  • Lacks periosteal layer
  • Callus formation limited, which affects healing
46
Q

In which part of NOF frac is risk of complications particularly high?

A

Subcapital and Transcervical. They’re intra-capsular.
Basicervical is extra-capsular

Risks include AVN, malunion

47
Q

Gustilo-Anderson classification for open fracs?

A

Mechanism energy
Soft tissue damage
Wound size
Contamination
Frac comminution
Periosteal stripping
Skin coverage

Lol go google its too long

48
Q
A
49
Q

What is greenstick fracture?

A

Fracture in immature bone.
Cortex bends rather than breaks

50
Q
A
51
Q
A