DSA: Sprains, Strains, & Fractures

Question 1

Distal Femur Fracture

Answer 1

Question 2

Femoral Shaft Fracture

Answer 2

Question 3

Hip Dislocation

Answer 3

Question 4

Hip Fracture

Answer 4

Question 5

Fibula Fracture

Answer 5

Question 6

Ottawa Knee Rules

Answer 6

Question 7

Collateral L Injury of the Knee

Answer 7

Question 8

Cruciate L Injury of the Knee

Answer 8

Question 9

Meniscus Injury

Answer 9

Question 10

Patella Injury

Answer 10

Question 11

Tibial Plateau Fracture

Answer 11

Question 12

Ottawa Ankle Rule

Answer 12

Question 13

Ankle Dislocation

Answer 13

Question 14

Lateral Malleolus Fracture

Answer 14

Question 15

Medial Malleolus Fracture

Answer 15

Question 16

Bimalleolar/Trimalleolar Fractures

Answer 16

Question 17

Maisonneuve Fracture

Answer 17

Question 18

Pilon/Tibial Plafond Fracture

Answer 18

Question 19

Calcaneal Body/Extra-articular Calcaneal Foot Fractures

Answer 19

Question 20

Midfoot Fracture

Answer 20

Question 21

Navicular Fracture

Answer 21

Question 22

Cuboid and Cuneiform Fractures

Answer 22

Question 23

Lisfranc Injury

Answer 23

Question 24

Metatarsal Fracture

Answer 24

Question 25

Proximal 5th Metatarsal Fracture

Answer 25

Question 26

Toe Fracture

Answer 26

Question 27

Toe Dislocation

Answer 27

Question 28

Open vs. Closed Fracture

Answer 28

* *Open fracture**: fracture with direct communication to the external environment * *Closed fracture**: broken bone with no direct communication to the external environment

Question 29

What are the initial steps in managing a fracture in the ED?

Answer 29

Question 30

# Define the following fracture types: complete tranverse oblique spiral comminuted incomplete (4 subtypes)

Answer 30

Question 31

What is an important rule on clinical imaging of joint injuries?

Answer 31

image the joint aboe and below

Question 32

What is the Salter-Harris classification used for?

Answer 32

description of physeal fractures in children

Question 33

When splinting an injury, what goes on the inner, middle, and outer layers?

Answer 33

Question 34

What complications can be seen with splinting?

Answer 34

compartment syndrome ischemia neurologic injury thermal injury pressure sore skin breakdown infection dermatitis joint stiffness

Question 35

It is important to document what in regards to physical findings?

Answer 35

document findings **before and after** splinting

Question 36

How much pain meds should be given?

Answer 36

no more then **3-7 days worth** (only give enough to get to next appointment)

Question 37

What is the MOA of femoral shaft fractures?

Answer 37

most commonly: MVC, penetrating tauma falls in elderly **non-accidental** trauma in kids

Question 38

When should you not use a traction splint in a femoral shaft fracture?

Answer 38

**concurrent fracture/dislocation of the ispilateral hip, knee of ankle**

Question 39

The pain with a fibula fracture is worsened with...

Answer 39

foot eversion

Question 40

What do you see on exam with MCL and LCL injuries?

Answer 40

MCL - joint laxity _without_ stress test LCL - joint laxiety _with_ varus stress test

Question 41

When do you need a consult with a patella dislocation?

Answer 41

**non-lateral dislocations** --\> often need surgery

Question 42

When is it especially important to get a CT with tibial plateau fractures?

Answer 42

**unexplained knee effusion**

Question 43

What are the indications for surgery with tibial plateau fractures?

Answer 43

**poly trauma** **communited fractures** **open fractures** **significant soft tissue injury** (--\> inc risk of compartment syndrome)

Question 44

Who does the Ottwa Ankle rules not apply to?

Answer 44

pregnant women intoxicated pts head injuries pts under 6

Question 45

What injuries are included in a Maisonneuve Fracture?

Answer 45

proximal fibula fracture distal tibiofibular syndesmosis injury deltoid ligament rupture _or_ medial malleolus fracture

Question 46

What injury may show a Mondor sign?

Answer 46

calcaneal body/extra articular **calcaneal foot fractures** Mondor sign - heel hematoma

Question 47

What is the most common fracture bone of the midfoot?

Answer 47

**navicular** most common subtype is dorsal avulsion fracture

Question 48

When viewing the cuboid vs. cuneiform, which images are best?

Answer 48

cuboid -medial oblique cuneiform - lateral and lateral oblique

Question 49

What injury usually requires CT to evaluate for occult fractures?

Answer 49

lisfranc injury

Question 50

What medications may be given in the ED to prevent future complications of a fracture?

Answer 50

**tetatnus prophylaxis** **IV ABs** (first gen cephalosporin, aminoglycoside, piperacillin...)

Question 51

What two Salter-Harris classification that can be easy to mix up?

Answer 51

**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

Question 52

What is a unique indication for posterior knee splints?

Answer 52

**pt with legs too large for knee immbolizer** _others_: patella fracture/dislocation, patella or quads tendon injury, soft tissue injuries of the knee