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Musculoskeletal > Fracture management > Flashcards

Fracture management Flashcards

1
Q

What mechanism of injury commonly causes humeral neck fractures?

A

Falling onto an outstretched hand with osteoporotic bone.

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2
Q

Most common humeral neck fracture?

A

Surgical neck fracture with medially displacement of the humeral shaft due to the pec major pull.

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3
Q

Minimally displaced proximal humeral fracture management?

A

Conservative- with sling and gradual return to mobilisation.

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4
Q

Persistently displaced humeral neck fractures?

A

Internal fixation (plate, screws, wires or IM nails)

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5
Q

Humeral head splitting fractures?

A

Replacement- arthroplasty.

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6
Q

What is more common, anterior or posterior shoulder dislocation?

A

Anterior

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7
Q

Mechanism of injury of traumatic anterior shoulder dislocation?

A

An excessive internal rotation force.

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8
Q

Bankurt lesion

A

Anterior shoulder dislocation resulting in detachment of the anterior glenoid labrum and capsule.

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9
Q

Hills-sachs lesion

A

Posterior humeral head can impact on the anterior glenoid producing an impaction fracture of the posterior head.

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10
Q

Nerve at risk in anterior shoulder dislocation

A

Axillary nerve

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11
Q

Sign of axillary nerve damage?

A

Loss of sensation in the badge patch area

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12
Q

What confirms an anterior shoulder dislocation?

A

Xray- if unsure use two views.

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13
Q

Management of anterior shoulder dislocation?

A

Closed reduction

Then use of sling for 2-3 weeks.

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14
Q

Anterior shoulder dislocation and greater tuberosity fracture?

A

Closed reduction then ORIF the fracture.

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15
Q

Mechanism of injury for a posterior shoulder dislocation

A

Posterior force on the adducted internally rotated arm.

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16
Q

Treatment of posterior shoulder dislocation

A

Closed reduction and sling.

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17
Q

How do acromioclavicular injuries usually occur?

A

Falling onto the point of the shoulder.

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18
Q

Treatment of acromioclavicular injuries?

A

Conservative management

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19
Q

Who gets surgery in acromioclavicular injuries?

A

Those with chronic pain.

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20
Q

Management of a humeral shaft fracture?

A

Conservative unless non-union.

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21
Q

Intra-articular distal humeral fractures?

A

ORIF

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22
Q

Olecranon fractures?

A

ORIF with plate and screws.

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23
Q

Mechanism of injury for olecranon fractures?

A

Fall onto the point of the elbow with contraction of the triceps muscle.

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24
Q

Radial head fractures- minimally displaced?

A

Conservatively.

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25
Q

Radial head fractures-comminuted?

A

ORIF if the fragment is large.

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26
Q

Fracture of the ulnar shaft is also known as

A

Nightstick fracture

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27
Q

Fracture of both bones in the forearm

A

ORIF

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28
Q

Monteggia or Galeazzi fracture?

A

ORIF

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29
Q

Colles fracture mechanism of injury?

A

Fall onto outstretched arm

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30
Q

Minimally displaced or angulated Colles fractures?

A

Splintage

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31
Q

Largely displaced Colles fracture?

A

ORIF with dorsal plate and screws

32
Q

Smiths fracture management

A

ORIF using volar plate and screws.

33
Q

Bartons fracture management

A

ORIF

34
Q

Comminuted intra-articular distal radial fractures

A

External fixation

35
Q

Scaphoid fracture mechanism of injury

A

Fall onto outstretched hand.

36
Q

Undisplaced scaphoid fractures

A

Plaster cast for 6-12 weeks

37
Q

Displaced scaphoid fractures

A

Screw fixation

38
Q

3rd, 4th and 5th MCP fracture

A

Conservative

39
Q

Boxers injury

A

Likely to damage 5th MCP

Up to 45 degrees of angulation can be tolerated- however rotational deformities can not.

40
Q

Treatment of boxers injury

A

Strap to next finger.

41
Q

Any suspicion of fight bite in boxers injury

A

Explore in theatre.

42
Q

Management of phalangeal fractures

A

Neighbouring strapping or splint age

43
Q

Significantly displaced phalangeal fractures

A

K wiring or small screws.

44
Q

Intracapsular hip fractures

A

Hemiarthroplasty or total hip replacement

45
Q

Extracapsular hip fractures

A

Dynamic hip screw

46
Q

Subtrochanteric fracture

A

IM nail

47
Q

Pubic rami fractures

A

Conservative

48
Q

Greater trochanteric fractures

A

Conservative

49
Q

Unstable femoral shaft fractures

A

IM nailing

50
Q

Stable femoral shaft fractures

A

Thomas splint

51
Q

Distal extra-articular femur fractures

A

Not too distal- IM nail

Distal- plate and screws

52
Q

Distal intra-articular femur fractures

A

Plate and screws

53
Q

Proximal tibial fractures

A

If high energy and substantial soft tissue damage may need external fixation
Rigid fixation

54
Q

Intra-articular proximal tibial fractures

A

Plate and screws

55
Q

Low energy tibial shaft fracture

A

Conservative

56
Q

High energy tibial shaft fracture

A

IM nailing.

57
Q

Distal tibial shaft fracture

A

May have too much soft tissue swelling- therefore need to externally fixate until safe to go in and put plate and screws.

58
Q

Intra-articular fibula fracture also known as?

A

Pilon fracture

59
Q

Significant soft tissue damage in intra-articular distal fibular fracture

A

Urgent external fixation

Internally fixate once soft tissues have settled.

60
Q

Isolated distal fibular fracture?

A

Conservative

61
Q

Bimalleolar fractures

A

ORIF

62
Q

Fractures with talar shift

A

ORIF

63
Q

Stable ankle fracture

A

Walking cast or splint age for 6 weeks.

64
Q

Falling from height you are likely to fracture your?

A

Calcaneous

65
Q

Talar fracture

A

ORIF

66
Q

Lisfranc fracture

A

ORIF

67
Q

5th MTP fracture

A

Walking cast, bandaging and stout boot

68
Q

1st MTP fracture

A

ORIF

69
Q

What might you use to view acetabulum fractures?

A

CT after Xray

70
Q

Undisplaced or small acetabulum fractures?

A

Conservative

71
Q

Unstable acetabulum fractures

A

ORIF in young

Older- hip replacement

72
Q

Low energy pubic rami fracture in the elderly

A

Conservative

73
Q

Lateral compression fracture description

A

Side impact where one half of the pelvis is displaced medially.

74
Q

Vertical shear fracture description

A

Axial force on one hemipelvis where the affected side is displaced superiorly.

75
Q

Anteroposterior compression injury description

A

Wide distribution of the pubic symphysis and the pelvis opens up. Substantial bleeding occurs.

76
Q

Open book (anteroposterior compression) pelvic fractures management

A

Reduce to stop the blood loss. Maybe use an external fixation.

Musculoskeletal (36 decks)

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