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MDEMO - Orthopaedics > Fracture Types > Flashcards

Fracture Types Flashcards

1
Q

ANKLE FRACTURES

  • what classification?
  • Type A?
  • Type B?
  • Type C?
  • also have Maisonneuvre fracture - leads to widening of ankle joint?
A
  • Weber’s classification
  • Type A - below level of ankle joint - stable - give PoP or ORIF
  • Type B - at the level of the ankle joint - unstable - require ORIF
  • Type C - above the level of ankle joint - unstable - require ORIF
  • spiral fibular fracture - needs surgery
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2
Q

CHARCOT’S JOINT

  • seen in whom?
  • joints are typically?
  • bony growths?
A
    • Neuropathic arthropathy seen in diabetics with peripheral neuropathy
    • red, hot and swollen
    • Bony growths/spurs due to plantar pressure.
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3
Q

WEDGE FRACTURES

  • where is it?
  • seen in whom?
  • how does it occur?
A
  • Wedge shaped vertebrae – with increased joint space on one side.
  • osteoporosis patients.
    • Compression fracture resulting from flexion.
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4
Q

OPEN FRACTURES

  • all patients with open fractures should receive?
  • complication of open fracture?
A
  • All patients with open fractures should receive cefalozin or equivalent gram +ve coverage
  • Also tetanus Ig administration.
  • compartment syndrome.
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5
Q

COMPARTMENT SYNDROME

  • most commonly found where? associated with which fractures?
  • what is it?
  • clinical features? - 6P’s
  • . If interstitial pressure exceeds capillary perfusion pressure for several hours (4-6) then you get ?
  • Tx?
A
  • Most commonly found in lower leg (commonly associated with tibial fractures)
  • increased interstitial pressure in an anatomical compartment.
  • muscle necrosis and eventually nerve necrosis may result
  • surgery.
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6
Q

ANKLE FRACTURES

  • what part of ankle has to be affected for it to go from a stable to an unstable fracture?
A
  • medial malleolus,
  • syndesmosis
  • medial deltoid ligament
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7
Q

HUMERAL FRACTURES

  • which nerve is at risk of injury?
  • nerve injury at this level results in?
A
  • radial nerve

- wrist drop and reduced sensation in first web space

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8
Q

SUPRACONDYLAR FRACTURES

  • most frequently occur in?
  • caused by FOOSH?
  • on XRay see what sign?
  • anterior or posterior fat pad normal?
  • injury to which nerve?
  • Tx?
A
  • Most frequently in children
  • Caused by FOOSH.
  • Presentation: see ‘Sail’ sign on lateral X-ray of elbow and represents anterior fat pad being lifted.
  • Anterior fat pad is normal but posterior fat pad is never normal
  • medial nerve
  • internal fixation with K wires
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9
Q

SUPRACONDYLAR FRACTURES

  • what classification?
  • along with medial nerve injury - what branch of the medial nerve can be affected and how do you test it?
  • along with medial nerve - what artery can be compromised?
A

Gartlands Classification

  • Type I – undisplaced
  • Type II – displaced but still intact.
  • Type III – completely displaced.
  • anterior interosseous nerve
  • assessed by flexion of the thumb and index finger to make an OK sign - if not then they have AIN palsy
  • brachial artery
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10
Q

HUMERAL MIDSHAFT FRACTURES

  • What type of fracture?
  • Tx? (if displaced or not)
  • what nerve can be affected?
A
  • Usually spiral fractures.
  • If displaced – ORIF, if not then plaster.
  • Complications include radial nerve injury or malunion.
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11
Q

CLAVICLE FRACTURE

  • typically presents where on clavicle?
  • Tx?
A
  • Typically presents in middle 1/3 of clavicle.

- Treatment – conservative management in a sling, malunion is common but accepted.

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12
Q

what is a pathological fracture?

A
  • Sudden onset pain
  • +/- loss of function
  • Following normal stress
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13
Q

DISTAL RADIAL FRACTURES

  • complications of radial head injuries?
  • what ligament surrounds the radial head?
  • colles’ fracture?
  • smiths fracture?
  • barton’s fracture?
  • which one of the three above is unstable?
  • how do you treat colles/smiths?
  • how do you treat Barton’s?

bennett’s fracture?

  • boxer’s fracture?
  • Tx for boxer’s/any pharyngeal fracture?
A
  • OA
  • annular ligament
  • colles fracture = dorsal angulation of distal segment
  • smiths = palmar angulation of distal segment
  • fracture line runs into joint whereas colles/smiths don’t
  • barton’s fracture

Colles/smiths - K wiring +/- ORIF

Barton’s - ORIF

  • bennett’s = fracture at 1st MCP (base of thumb)
  • fracture at distal end of 5th MCP - punching hard things
  • buddy/neihgbour strapping to 4th pharyngeal (goes for any pharyngeal fracture
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14
Q

tenderness in anatomical snuffbox?

what mechanism of fall?

complication if untreated?

Tx?

A

scaphoid fracture

  • FOOSH
  • avascular necorsis - may develop OA
  • undisplaced: PoP
  • DISPLACED : ORIF
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15
Q

classification of fractrure Management:

  • if closed + undisplaced?
  • if closed + minimal displacment)
  • if closed + grossly displaced?
  • if open ?
A
  • Closed fracture with no displacement – plaster.
  • Closed fracture with minimal displacement – manipulation under anaesthesia + plaster.
  • Closed with grossly displaced – ORIF or intramedullary nails.
  • Open fracture – external fixation.
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16
Q

NOF FRACTURES

  • Common in whom?
  • presentation?
  • When you look at neck of femur fractures – you follow what line to ensure that there is a smooth curvature and to help identify a fracture line?
  • intra or extracapsular at risk of AVN?
  • classification of intracapsular NOF fractures?
  • what is the catchy phrase for trying to remember Tx criteria ?
A

Hip fractures are common in elderly women due to osteoporosis.

Clinical presentation is a shortened, externally rotated lower limb which is unable to weight bear.

When you look at neck of femur fractures – you follow shenton’s line to ensure that there is a smooth curvature and to help identify a fracture line.

Intracapsular – at risk of AVN.

Garden’s classification of intracapsular neck of femur fractures:

Grade I – partial subcapital fracture.

Grade II – undisplaced subcapital fracture.

Grade III – partially displaced subcapital fracture.

Grade IV – displaced subcapital fracture.

Grade I + II try and screw, Grade III + IV, get the head out the door!!

17
Q

NOF FRACTURES

Fractures occurring between the lesser and the greater trochanters are called?

are they intra or extracapsular?

A

intertrochanteric

are extra-capsular as they occur out at the attachment of the hip joint capsule

18
Q

NOF FRACTURES

An extra-capsular (outside joint capsule) fracture you have two types:

intertrochanteric - Tx?
subtrochanteric - Tx?

A
  • Intertrochanteric – fix with a Dynamic Hip Screw (DHS).

- Subtrochanteric – fix with a intramedullary nail.

19
Q

In displaced neck of femur fracture the blood supply to the head of the femur may be disrupted - what is the blood supply affected?

A

femoral circumflex vessels).

20
Q

Hip Dislocation

  • occurs anteriorly or posteriorly?
  • presents as shortened limb that is internally or externally rotated?
  • complications?
  • Mx?
A
  • Occurs posteriorly.
  • Presents as a shortened limb that is internally rotated.

Complications include:

  • sciatic nerve damage,
  • AVN of femoral head and secondary OA.
  • Management: analgesia, reduce under sedation.
21
Q

Patellar Fracture

how do you get a patellar fracture ?

unable to do what leg movement?

if transverse fracture - Mx?

if longitudinal fracture - Mx?

A
  • Usually occurs due to direct fall onto knee.
  • Presentation: unable to straight leg raise.
  • If transverse fracture: ORIF with banding (most common).
  • If longitudinal fracture: non-operative, long leg cylinder caste.
22
Q

Tib-Fib Fractures

most common open fracture!!

  • require what Mx?
  • usually get fracture as a result of ?
A
  • Most common ‘open fractures’
  • Usually require external fixation.
  • As a result of a sporting injury
23
Q

Salter-Harris Classification

for whom?

ACRONYM:

I S
II  A
III L
IV T
V  ER

What is the most common type?

A

Childhood fractures – growth plate injuries

I  - S – Straight 
II – A- Above
III – L -Lower
IV – T - Through
V – ER – Erasure of growth plate.

TYPE 2 - 95% are this one

24
Q

PoP

  • how long for upper limb?
  • how long for lower limb?
  • Principles of plaster technique?
A

Upper limb is 6 weeks in plaster, lower limb usually 12-16.

Principles of plaster: cover fracture, joint above and below needs to be covered.

25
Q

what is arthroplasty?

in whom would you do a hemi or a full arthroplasty?

A

Surgical reconstruction or replacement of a joint.

Hemiarthroplasty (one side of the joint is replaced by a prosthesis used for elderly

whereas in younger active people do a full arthroplasty, commonly utilized in hip fractures, can be cemented or uncemented).

26
Q

COMPARTMENT SYNDROME

  • how is it diagnosed ?
  • death of muscle groups may occur within ?
  • Tx?
  • what may occur abnormally in urine post surgery?
A

intracompartmental pressure measurements :

  • pressures in excess of 20mmHg are abnormal
  • pressures in excess of 40mmHg are diagnostic
  • 4-6 hours
  • prompt fasciotomy
  • myoglobinuria -> renal failure
27
Q

BUCKLE FRACTURE

  • what is it ?
  • occurs in whom?

Tx?

A

Buckle, or torus, fractures are incomplete fractures of the shaft of a long bone

They typically occur in children aged 5-10 years.

As they are typically self-limiting they do not usually require operative intervention and can sometimes be managed with splinting and immobilisation rather than a cast

MDEMO - Orthopaedics (12 decks)

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