235. MSK Trauma

Question 1

Definitions of 
Strain
Sprain
Closed v Open Fracture
Reduction
Fixation
ORIF

Answer 1

Str: tear of muscle/tendon
spr: tear of ligament
Closed: broken bone, intact skin
Open: broken bone, skin violation (more worrisome, infection risk)
Reduction: aligning bone fragments to anatomic location
Fixation: holding bone in place (cast, plate, screw, rod) - NAIL goes through intramedullary
ORIF: open reduction internal fixation (incision and hardware to fix fracture)

Question 2

How to treat most MSK Trauma

Answer 2

RICE
Brace/Cast
PT/NSAIDs

Question 3

What is a dislocation and tx for it

Answer 3

Bone articulation pop out of place
Bigger bone = more urgent reduction (avascular necrosis)
Tx: closed fixation (pull into place)

Question 4

What is tx for open fracture

Answer 4

Irrigation (reduce infection), debridement (get rid of necrotic tissue), Fixation (none - case, external - rod, internal)

Question 5

Compartment Syndrome: what is it and tx

Answer 5

high pressure in cmpt = ischemia = permanent tissue damage
caused by edema and trauma
Presentation: pain on passive stretching, cmpt is rock hard/swollen, pallor, pulselessness, paralysis
Tx: FASCIOTOMY - incision to release pressure

Question 6

What is pathologic fracture? Why does it occur? Where does it occur? What is the most common distribution? Why?

Answer 6

Fracture through abnormal bone
Usually from metastatic disease
BLT with Kosher Pickle (breast, lung, thyroid, kidney, prostate)
Distributes to spine due to Batson’s Vertebral plexus (drains blood from viscera)