DSA: Sprains, Strains, & Fractures

Question 1

What adtl imaging might be useful for distal Femur Fracture?

What splint?

Answer 1

Question 2

Femoral Shaft Fracture

What imaging? How should we manage? What splint?

Answer 2

Question 3

Hip Dislocation

Imaging? Types of fx? Exam findings? Management?

Answer 3

Question 4

Hip Fracture

Imaging? Exam findings?

Answer 4

Question 5

Fibula Fracture

Mechanism? Exam finding? Splint?

Answer 5

Question 6

Ottawa Knee Rules (5)

Answer 6

1. over 55
2. tender patella
3. tender fibular head
4. can’t flex knee to 90
5. can’t bear weight

Question 7

Collateral Ligament Injury of the Knee

Mech for MCL/LCL? Exam findings?

Answer 7

Mech = all to flexed knee

• MCL = valgus and ER
• LCL = varus and IR

Exam

• MCL = joint lax w/o stress test
• LCL = joint lax w varus

Question 8

Cruciate Ligament Injury of the Knee

Mech ACL/PCL? Exam?

Answer 8

Mech = all to flexed knee

• ACL = valgus and ER or hyperextend
• PCL = post stress

Exam

• ACL = pos anterior drawer and lachman
• PCL = pos post drawer and sag sign

Question 9

Meniscus Injury

Mech? Exam?

Answer 9

Question 10

Patella Injury

Imaging? Mech of fx vs dislocation? Exam fx vs dislocation?

Answer 10

Question 11

Tibial Plateau Fracture

Imaging? Mech? Assc injuries (4)?

Answer 11

Question 12

Ottawa Ankle Rule (5)

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

Dorsolateral displaced metatarsals

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 above 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? where do we document?

Answer 35

document findings **before and after** splinting document physical findings (perfusion, neuro, anatomic position) in **objective**

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

Ottawa Foot Rule

Question 38

Exclusions of Ottawa ankle rule (3)

Answer 38

preggo intoxicated head injury

Question 39

What rule has a sensitivity of 100% w moderate specificity?

Answer 39

Ottawa Ankle rule

Question 40

Why would we order a CT in a pt w **knee** **effusion** and **pain** that is worse with varus/valgus force @ the knee?

Answer 40

Occult **tibial** **plateau** fx

Question 41

What view should you consider with patella fx?

Answer 41

Sunrise view

Question 43

Which ankle dislocation is assc w fx of the ant **distal** tibia and obstruction of the **dorsalis pedis** artery?

Answer 43

anterior ankle dislocation

Question 44

Which ankle dislocation is assc w fx of the **malleoli** and **distal** **tibia** and _deltoid_ ligament injury?

Answer 44

Lateral ankle dislocation

Question 45

Which ankle dislocation is assc w fx of the lateral malleollus and disruption of the tibiofibular **syndesmosis**?

Answer 45

Posterior ankle dislocation

Question 46

Which ankle dislocation is assc w a **shortened** leg and fx **calcaneus**?

Answer 46

Superior ankle dislocation

Question 47

What is the most fractured bone in the mid foot?

Answer 47

Navicular

Question 48

Which bones in the midfoot always fracture together?

Answer 48

Cuboid and cuneiform

Question 49

Which fx is assc w **tibial n, posterior tibial a, and peroneal a injury**?

Answer 49

Trimalleolar fracture

Question 50

Which fx is assc w **tibial** n & **posterior** **tibial** a injury?

Answer 50

Medial Malleolus fx

Question 51

Which fracture may warrant an MRI?

Answer 51

Hip fracture: look for occult fx Leg may be shortened and ER

Question 52

Which fx may warrant a CT angiogram if there are dec pulses post-reduction?

Answer 52

Distal femur fx

Question 53

What 4 injuries make-up a Maisonneuve fx?

Answer 53

1. Proximal fibula fx 2. Tibiofibular syndesmosis injury 3. Deltoid lig rupture 4. OR medial malleolus fx

Question 54

What 2 signs may indicate calcaneal fx?

Answer 54

Bohlers angle \<20 degrees Mondor sign: heel hematoma

Question 55

What will **piano** **key** sign, + **pronation-AB**duction test, + tarsal metatarsal **squeeze** test indicate?

Answer 55

Lisfranc injury = dorsolateral displaced metatarsals

Question 56

What fx might injure the medial planter artery?

Answer 56

Metatarsal artery