Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Trauma and Orthopedics YR3 > Distal Radial Fracture > Flashcards

Distal Radial Fracture Flashcards

1
Q

History questions for someone with suspected distal radial fracture

A
  • Mechanism of fall
  • Hand position when fall
  • Pain - SQITARS
  • PMH - RF for OP, previous #, rheumatological disease?
  • DH - steroids, OTC, anticoags
  • Social - smoker?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common 3 types of distal radial #

A
  • Smiths
  • Colles - most common
  • Bartons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Deformity and mechanism seen in Colles vs Smiths #

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Assessing NV status of hand

A
  • Median - OK sign, touch radial surface of distal 2nd digit
  • Ulnar - Pinch paper, look for froments sign, touch ulnar surface of 5th digit
  • Radial - thumb extension against resistance, dorsal surface of 1st webspace
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Deformity seen on Colles x-ray

A
  • Dorsal angulation
  • Decrease in volar tilt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is measured on x-ray when diagnosing distal radial # and normal values?

A
  • Volar tilt - 11-24 degrees (negative = dorsal angulation)
  • Inclination - 19-25 degrees
  • Radial height - 11-12mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is volar tilt measured?

A
  • Lateral view
  • Perpendicular to long axis of radius
  • Tangent line along dorsal to palmar surface of radius
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is inclination measured of distal radius?

A
  • PA view
  • Line perpendicular to long axis of radius - along articular surface
  • Another line drawn down from tip of styloid process (tip of radius)
  • <15 = inclination for operative management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is distal radius height measured?

A
  • Distal ulna to styloid process space
  • Often reduced in fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does inclination, radial height and volar tilt aid management direction of distal radial#?

A
  • Volar displaced # are unstable and often require open reduction and surgical fixation
  • In over 65s, non-surgical management should be primary for dorsally displaced (unless NV compromise)
  • Under 65s consider volar tilt, inclincation, radial height and intra-articular joint space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

General management for distal radius #

A
  • Traction and manipulation using local anaesthetic - haematoma block or Biers block (into vein with tourniquet on)
  • THEN below the elbow backslab cast
  • Rpt x-ray in one week: If significantly still displaced/unstable or radiocarpal distance >2mm - surgery (open reduction internal fixation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is used for ORIF?

A
  • Locked volar plating
  • K wires - Kirschner wire, these are recommended as they are cheaper and a quicker procedure with no difference in outcome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acceptable values for post reduction volar tilt and inclination

A
  • Radial length (>5mm)
  • Radial angulation or tilt (< 15° dorsal or 20° volar)
  • Radial inclination (>15°) are among the radiological markers for acceptable reduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TEach me surgery diagnostic values for distal radial #

A
  • Radial height less than 11mm
  • Radial inclination less than 22 degrees
  • Radial Volar tilt more than 11 degrees

Not sure about this compared to the other values I found

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of open reduction and internal fixation

A
  • Infection
  • Neurovascular injury
  • Tendon rupture
  • Stiffness
  • Malunion/non-union
  • Broken metal work
  • Re-fracture
  • Carpal tunnel
  • Complex regional pain syndrome
  • Anaesthetic risk
  • PE/DVT
  • Death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long until mobilisation post open reduction and internal fixation?

A
  • 6 weeks for bone to heal
  • Another 6 weeks for bone to be as strong as before
  • However, some people it takes 6-12 months to use as normal
17
Q

DRAFT trials suggest best option for ORIF is

A
  • Kirshner wires - cheaper, quicker procedure
  • Same outcomes as volar plating
18
Q

Most common MOA of distal radial #

A
  • FOOSH
  • = forced supination or pronation
  • = increased impaction load onto distal radius
19
Q

MOI of Colles #

A
  • Dorsal angulated and dorsal displaced #
  • Person falls forwards, puts outstretched hand in front of them
  • Fall onto pronated hand, forces wrist to supinate
20
Q

MOI for Smith’s #

A
  • Volar angulated +/- volar displacement
  • Falling backwards anf planting out stretched hand behind body
  • Fall onto supinated hand
  • = forced pronation action
21
Q

Bartons fracture

A
  • Intraarticular (unlike Smith’s and Colles)
  • Associated dislocation of radiocarpal joint
  • Can be volar (more common) or dorsal depending on which rim of radius is involved
22
Q

Main complications of distal radius #

A
  • Malunion - poor realignment leads to shortened radius compared to ulnar = reduced wrist motion, wrist pain, reduced forearm rotation - can treat with corrective osteotomy(cut bone to restore aligment) of malunion
  • Median nerve compression - more common if heal in malunion
  • OA - esp if intraarticular involvement
23
Q
A

Trauma and Orthopedics YR3 (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions