Fracture Management: Lower Limb Flashcards
what is shenton’s line?
the curved line between the medial edge of the neck of the femur and the lateral edge of the superior pubic ramus
what fracture does a blurry shenton’s line indicate?
neck of the femur fracture
a proximal femur fracture is a fracture of what part of the body?
the hip
what does intracapsular mean?
a fracture of a bone that is enveloped by the hip joint capsule
what does an extracapsular fracture mean?
a fracture of bone below the hip joint capsule
are neck of the femur fractures an extra or intracapsular fracture?
intracapsular
name 3 types of fracture than can occur in the hip?
subcapital
intertrochanteric
subtrochanteric
management of a subcapital hip fracture for young and old patients?
THR- young
hemiarthroplasty- old
which of these fractures is extracapsular and which are intracapsular:
subtrochanteric
subcapital
intertrochanteric
extra
intra
extra
management of an intertrochanteric hip fracture?
internal fixation or dynamic hip screw
management of a subtrochanteric hip fracture?
internal fixation or dynamic hip screw
which kind of hip fracture needs stabilised with a thomas splint before any surgery?
subtrochanteric
what 2 sites of the thigh area can be fractured?
distal femur
femoral shaft
2 kinds of distal femur fracture?
intraarticular - involving knee
extraarticular - not involving knee
management of an extra-articular distal femur fracture?
IM nail if higher up
plating if distal
management of an intra-articular distal femur fracture?
anatomical reduction with rigid fixation/plate and screws
management of a stable femoral shaft fracture?
analgesia if femoral nerve blocked
thomas splint
management of an unstable femoral shaft frature?
IM nailing
most common cause of a distal femur fracture?
fall onto flexed knee and have osteoporosis
complications of a femoral shaft fracture?
ARDS
fat embolism
most common cause of a femoral shaft fracture?
high energy
what 3 areas of the tibia can be prone to fracture?
proximal tibia
tibial shaft
distal tibia
what 2 kinds of fracture can occur in a proximal tibial fracture?
intraarticular- involving knee
extraarticular- not involving knee
what 2 kinds of fracture can occur in a distal tibial fracture?
intraarticular- involving ankle
extraarticular- not involving ankle
cause of a proximal tibial fracture?
VALGUS stress i.e from high energy or osteoporosis
what anatomical condition can occur after a proximal tibial fracture?
foot drop due to fibular nerve injury
management of any proximal tibial fracture?
if high energy do high temp external fixation
if not do anatomical reduction and rigid fixation
what percentage of displacement and degree of angulation would qualify for a knee cast in a tibial shaft fracture?
<50% displacement
<5 degrees angulation
how would you manage a comminuted tibial shaft fracture?
IM nailing with plastics assistance
external fixation
commonest cause of compartment syndrome after trauma?
a tibial shaft fracture
how long does healing of a tibial shaft fracture take?
16 weeks
how would you manage a stable extraarticular distal tibial fracture?
conservatively
how would you manage an extraarticular distal tibial fracture that is very low down in the bone?
plate
how would you manage an extraarticular distal tibial fracture that isn’t too low down in the bone?
IM nailing
what is the most serious of all kinds of tibial fracture?
intraarticular distal tibial fracture
management of an intraarticular distal tibial fracture?
early ORIF or bridging external fixation if soft tissue not ok
THEN bone graft
another word for an intraarticular distal tibial fracture?
pilon fracture
name the two areas of the ankle that can be fractured
distal tibia
distal fibula
what would make a distal fibular ankle fracture unstable?
if the deltoid ligament was ruptured
management of a stable distal fibular/tibial fracture
walking cast or splint for 6 weeks
conservative
how would you manage an unstable distal fibular fracture?
ORIF with plates and screws
mnemonic for the salter harris classification?
S traight across = type 1 A bove = 2 L lower/below = 3 T wo/through = 4 E = 5 R = 6
what joint can be affected in a calcaneal fracture?
subtalar joint
cause of a calcaneal fracture?
fall from height
management of heel fractures?
ORIF
management of a midfoot fracture?
closed or open reduction with screw fixation
another word for a midfoot fracture?
lisfranc fracture
management of a stable metatarsal fracture?
moonboot for 4-6 weeks
what fracture is commonly referred to as the “dancer’s fracture”
fracture of the base of MT 5
management of a proximal metatarsal fracture?
fixation
bone grafting + fixation if bad
common metatarsal for a stress fracture?
2
how should you manage an open fracture of a toe?
debridement and stabilisation with wires
