DSA: Sprains, Strains, & Fractures Flashcards
Distal Femur Fracture
Femoral Shaft Fracture
Hip Dislocation
Hip Fracture
Fibula Fracture
Ottawa Knee Rules
Collateral L Injury of the Knee
Cruciate L Injury of the Knee
Meniscus Injury
Patella Injury
Tibial Plateau Fracture
Ottawa Ankle Rule
Ankle Dislocation
Lateral Malleolus Fracture
Medial Malleolus Fracture
Bimalleolar/Trimalleolar Fractures
Maisonneuve Fracture
Pilon/Tibial Plafond Fracture
Calcaneal Body/Extra-articular Calcaneal Foot Fractures
Midfoot Fracture
Navicular Fracture
Cuboid and Cuneiform Fractures
Lisfranc Injury
Metatarsal Fracture
Proximal 5th Metatarsal Fracture
Toe Fracture
Toe Dislocation
Open vs. Closed Fracture
- *Open fracture**: fracture with direct communication to the external environment
- *Closed fracture**: broken bone with no direct communication to the external environment
What are the initial steps in managing a fracture in the ED?
Define the following fracture types:
complete
tranverse
oblique
spiral
comminuted
incomplete (4 subtypes)
What is an important rule on clinical imaging of joint injuries?
image the joint aboe and below
What is the Salter-Harris classification used for?
description of physeal fractures in children
When splinting an injury, what goes on the inner, middle, and outer layers?
What complications can be seen with splinting?
compartment syndrome
ischemia
neurologic injury
thermal injury
pressure sore
skin breakdown
infection
dermatitis
joint stiffness
It is important to document what in regards to physical findings?
document findings before and after splinting
How much pain meds should be given?
no more then 3-7 days worth
(only give enough to get to next appointment)
What is the MOA of femoral shaft fractures?
most commonly: MVC, penetrating tauma
falls in elderly
non-accidental trauma in kids
When should you not use a traction splint in a femoral shaft fracture?
concurrent fracture/dislocation of the ispilateral hip, knee of ankle
The pain with a fibula fracture is worsened with…
foot eversion
What do you see on exam with MCL and LCL injuries?
MCL - joint laxity without stress test
LCL - joint laxiety with varus stress test
When do you need a consult with a patella dislocation?
non-lateral dislocations –> often need surgery
When is it especially important to get a CT with tibial plateau fractures?
unexplained knee effusion
What are the indications for surgery with tibial plateau fractures?
poly trauma
communited fractures
open fractures
significant soft tissue injury (–> inc risk of compartment syndrome)
Who does the Ottwa Ankle rules not apply to?
pregnant women
intoxicated pts
head injuries
pts under 6
What injuries are included in a Maisonneuve Fracture?
proximal fibula fracture
distal tibiofibular syndesmosis injury
deltoid ligament rupture or medial malleolus fracture
What injury may show a Mondor sign?
calcaneal body/extra articular calcaneal foot fractures
Mondor sign - heel hematoma
What is the most common fracture bone of the midfoot?
navicular
most common subtype is dorsal avulsion fracture
When viewing the cuboid vs. cuneiform, which images are best?
cuboid -medial oblique
cuneiform - lateral and lateral oblique
What injury usually requires CT to evaluate for occult fractures?
lisfranc injury
What medications may be given in the ED to prevent future complications of a fracture?
tetatnus prophylaxis
IV ABs (first gen cephalosporin, aminoglycoside, piperacillin…)
What two Salter-Harris classification that can be easy to mix up?
Type I - transverse fracture thu physis
and
Type V - compression fracture thru physis
- Type V is often dx retrospectively after arrest of growth
- Suspect Type V if MOI involves significant axial load
What is a unique indication for posterior knee splints?
pt with legs too large for knee immbolizer
others: patella fracture/dislocation, patella or quads tendon injury, soft tissue injuries of the knee
