ED 2 Lower Extremity Flashcards

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1
Q

what is the only type of stable pelvic fracture?

A

ramus fracture; the only one treated without surgery

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2
Q

how will most patients with a pelvic fracture present?

A

groin pain, inability to walk following blunt trauma

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3
Q

what must you ensure before you insert a foley catheter into your patient with an unstable pelvic fracture?

A

make sure no blood at meatus or urethra

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4
Q

what are the four types of hip fractures?

A

1) femoral head
2) surgical neck
3) intertrochanteric
4) subtrochanteric

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5
Q

how will patient with a hip fracture present? how will their leg be positioned?

A

leg pain

leg shortened and EXTERNALLY rotated

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6
Q

how do we manage hip fractures?

A

ALL get admitted for surgery!

foley catheter, pain control

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7
Q

most common cause of hip dislocation? how will patient’s leg look when they present?

A

MVA

leg shortened and INTERNALLY rotated

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8
Q

how do we manage hip dislocations in the ED? reduction techniques?

A

SEDATE THEM!

1) hold pressure down on pelvis, other person pulls affected leg hard towards them
2) yank hard upwards while un top of person and stabilizing pelvis

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9
Q

a femur fracture in a young kid should make you concerned for what?

A

abuse

as with all long bone fx

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10
Q

what is the hallmark splint used for a femur fracture that can relieve pain and help neurovascular function?

A

traction splint (hare)

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11
Q

femur fractures always get what?

A

surgical fixation

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12
Q

which knee injury is considered a very high liability due to poor healing and outcomes?

A

tibial plateau fracture

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13
Q

why is diagnosing a tibial plateau fracture difficult? when should you consider it?

A

often non-displaced and difficult to see on x-ray

they will have pain out of proportion to exam, get a CT!

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14
Q

at which site is the fibula most common fractured? what is the most common mechanism of injury?

A

classically lateral malleolus

usually second to inversion injury

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15
Q

if you find a fibular fracture, what must you be absolutely sure to do?

A

check upwards for a maisonneuve injury! often the distal fracture radiates up and spirals, breaking the proximal fibula

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16
Q

treatment for a fibular fracture?

A

splint/non-weightbearing

this is a stable joint! but do have them FU with ortho

17
Q

what do we worry most about with bimalleolar/trimalleolar injuries?

A

mortise disruption (widened mortise) – be sure to reduce

18
Q

treatment for bimalleolar/trimalleolar injuries?

A

admit them! surgical TX definitive TX (unstable once mortise disrupted)

19
Q

a positive thompson’s test is pathognomonic for what?

A

achilles tendon rupture

20
Q

in what position do we splint an achilles tendon rupture?

A

splint in full PLANTAR flexion

21
Q

a fall from a height puts you at risk for what?

A

calcaneal injury