9-Trauma Flashcards
What does the primary survey of a trauma patient consist of?
ABCDE Airway Breathing Circulation Disability- assess neurologic status Exposure of patient and environmental control
What should always be asked with a break in the skin?
tetanus status
What is a clinical test for a fracture?
point tenderness over a fracture site
Name the appropriate classification for: distal phalangeal/nail
Rosenthal
Name the appropriate classification for: 1st Metatarsophalangeal
Jahss
Name the appropriate classification for: 5th met base
Stewart
Name the appropriate classification for: Lisfranc joint
Quenu & Kuss, Hardcastle
Name the appropriate classification for: navicular
Watson-Jones
Name the appropriate classification for: posterior tibial tendon
Conti (based on MRI findings)
Name the appropriate classification for: talar neck
Hawkins
Name the appropriate classification for: talar body
Sneppen
Name the appropriate classification for: talar dome
Berndt & Hardy, Fallot & Wy
Name the appropriate classification for: calcaneus
Rowe
Essex-Lopresti
Sanders
Name the appropriate classification for: anterior process of calcaneal fx
Degan
Name the appropriate classification for: ankle sprains
O’Donoghue, Leach, Rasmussen
Name the appropriate classification for: physeal ankle fx
Dias & Tachdijan
Name the appropriate classification for: pediatric physeal injuries
Salter-harris
Name the appropriate classification for: ankle fx
Lauge-Hansen, Danis-Weber
Name the appropriate classification for: Pilon fx (distal tibial metaphysis)
Ruedi & Allgower, Dias &Tachdjian
Name the appropriate classification for: Achilles rupture
Kuwada
Name the appropriate classification for: open fx
Gustillo
Name the appropriate classification for: non-unions
Weber & Cech
Name the appropriate classification for: frostbite
Orr & Fainer, Washburn
Which is the most stable fx pattern?
transverse
what is the Vassal principle?
internal fixation of the primary fracture will assist in stabilization of the secondary fx
What are possible complciations of fx?
delayed union non-union pseudoarthrosis osteoarthritis AVN
what is the most common cause of non-healing for a bone fx?
improper immobilization
are dorsal or plantar Lisfranc dislocations more common?
dorsal- the plantar ligaments are stronger than dorsal
what are the ottawa ankle rules for obtaining ankle films?
inability to bear weight both immediately and in ED
bony tenderness at posterior edge or distal 6cm of lateral malleolus
bony tenderness at posterior edge or distal 6 cm of medial malleolus
what are the ottawa ankle rules for obtaining foot films?
inability to bear weight both immediatey and in the ED
bony tenderness at base of 5th met
bony tenderness at navicular
what is the classification system for talar dome lesions?
Berndt & hardy
what stages of Berndt & Hardy are often associated with lateral ankle ligament ruptures?
II, III. IV
What are the common locations of talar dome lesions and their mechanisms of injury?
*mnemonic- DIAL A PIMP
Dorsiflexion/ inversion –> anterior lateral lesions
plantarflexion/inversion –> medial posterior lesions
What is teh Hawkins sign?
presence of subchondral talar dome osteopenia seen 6-8 weeks after talar fx signifiying intact vascularity
*ABSENCE of sign implies AVN
what is the sneppen classification?
talar body fx
what percentage of fx of the talus involve the calcaneus?
60%
What is Mondor’s sign?
plantar, rearfoot ecchymosis that is pathogneumonic for calcaneal fx
how is bohler’s angle affected by a calcneal fx?
decreases with intra-articular calcaneal fx
how is teh critical angle of gissane affected by a calcaneal fx?
increases with intra-articular calcaneal fx
what fx are commonly associated with calcaneal fx?
vertebral fx- esp L1
femoral neck
tibial plateau
what is the mechanism of injury for an anterior process fx?
inversion with plantarflexion
what are some clinical exam tests/ radiographic imaging for ligament pathology?
anterior draw test calcaneofibulr stress inversion abductions tress ankle arthrogram peroneal tenography
Describe the talar tilt test.
> 10 deg indicates rupture of CFL
what are teh clinical symptoms of an Achilles tendon rupture?
pain with history of "pop" weakness or loss of fxn palpable dell in area of ruptured tendon inability to perform single leg rise increased ankle dorsiflexion
what is the thompson test?
a positive test results when squeezing of the calf does NOT plantarflex the foot
What is the Hoffa sign?
increased dorsiflexion compared to contralateral leg with the inability to perform a single leg rise test
what is a radiographic finding of an Achilles tendon rupture?
disruption of kager’s triangle
what is te most common location for the achilles tendon to rupture?
1.5- 4.0 cm proximal to calcaneal insertion
Name the fx: Pott fx
bimalleolar fx
Name the fx: Cotton fx
tri-malleolar fx
Name the fx: Tillaux-Chaput
avulsion of AITFL from the anterior lateral tibia
Name the fx: Wagstaff
avulsion of AITFL from the anterior medial fibula
Name the fx:Volkmann
avulsion of PITFL from the tibia
Name the fx: Maisonneauve
proximal fibular fx
What is the most common mechanism of injury for an ankle fracture?
SER (supination- external rotation)
what is the MOI causing a transverse lateral malleolar fx?
SAD I
what is the MOI causing a short, oblique medial malleolar fx?
SAD II
what is teh MOI causing a short, oblique lateral malleolar fx (AP view)?
PAB III
What is teh MOI causing a spiral, lateral malleolar fx with a psoterior spike (AP and lateral views)?
SER II
what is the MOI to the ankle with a high fibular fx? What is this fx called?
PER II
maisonneauve fx