Fracture Treatment review

Question 1

Buckel (torus) fx

Answer 1

Volar/Dorsal forearm splint. Follow with short arm cast.

Question 2

Colles fx

Answer 2

Double sugar-tong splint. Follow with:

Stable fx: closed reduction/casting.

Unstable fx: pinning.

Question 3

Supracondylar humerus fx

Answer 3

Long arm posterior splint. Refer to ortho.

Question 4

Greenstick fx

Answer 4

Long arm splint. Ortho referral.

Question 5

Monteggia fx/dislocation

Answer 5

Stabilize and send. Check for neuro and vascular compromise.

Question 6

Scaphoid fx

Answer 6

Thumb spica splint/cast

Question 7

Salter-Harris categories for growth plate fx.

Answer 7

I: Same (same level as growth plate)

II: Above (in metaphysis)

III: Lower (through epiphysis)

IV: Through (epiphysis, physis, metaphysis.

V: Compression of physis.

Question 8

Growth plate fx

Answer 8

Immobilize with splint. Ortho referral.

Question 9

Clavicle fx

Answer 9

Non-displaced = conservative tx

• sling
• gental ROM exercises

Question 10

When do we refer a clavicle fx?

Answer 10

1. Risk of non-union
2. Displacement greater than 1 bone width
3. Distal clavicle fx
4. Elderly
5. Athlete

Question 11

Distal 5th metatarsal fx (Dancer’s fx)

Answer 11

1. Immobilize in posterior mold splint
2. Non-weight bearing
3. Refer to ortho - short leg cast with toe plate extension

Question 12

Stress fx

Answer 12

• Conservative tx: NSAIDs, rest, time.
• 5th metatarsal, navicular, or femoral neck: immobilization

Question 13

Jones fx 5th metatarsal fx

Answer 13

High incidence of delated union and malunion.

Ortho consult.

Question 14

Pseudo-Jones fx

Answer 14

• Extra-articular: walking cast or stiff shoe 2-3 weeks
• Intra-articular: non-weight bearing cast for 6-8 weeks