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Orthopaedics > Fractures > Flashcards

Fractures Flashcards

1
Q

How can the types of hip fracture be broadly categorised?

A

Intracapsular vs. extracapsular

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2
Q

How can you determine if a fracture is intracapsular?

What are the types of intracapsular fracture?

A

Intracapsular fracture = proximal to intertrochanteric line

Types of intracapsular fracture:

  • Displaced
  • Non-displaced
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3
Q

What are the types of extracapsular fracture?

A
  • Intertrochanteric

- Subtrochanteric

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4
Q

How do you typically manage a non-displaced intracapsular fracture?

A

Internal fixation

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5
Q

How do you typically manage a displaced intracapsular fracture?

A

Either THR or hemiarthroplasty (may opt for hemiarthroplasty in older, more frail patients)

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6
Q

How do you typically manage an intertrochanteric fracture?

A

Dynamic hip screw (DHS)

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7
Q

How do you typically manage a subtrochanteric fracture?

A

Intramedullary nail

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8
Q

What are the typical symptoms and signs of a hip fracture?

A

Symptoms:

  • Pain
  • Inability to weight bear

Signs:
- Shortened, abducted and externally rotated leg

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9
Q

What is the diagnostic investigation for hip fracture?

A

XR hip (AP and lateral views)

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10
Q

What is the name for the continuous curving line formed by the medial border of the femoral neck, continuing to the inferior border of the superior pubic ramus?

A

Shenton’s line - disruption of this line is a key sign of #NOF

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11
Q

NICE guidelines recommend that surgery for a hip fracture is carried out within (…?) hours of the patient being admitted to hospital

A

48 hours

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12
Q

What is a Colle’s fracture?

A

Transverse fracture of the distal radius

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13
Q

What is typically the cause of a Colle’s fracture?

A

FOOSH - fall onto outstretched hand

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14
Q

What might you see on examination in a patient with a Colle’s fracture?

A

“Dinner fork deformity”

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15
Q

What is typically the cause of a scaphoid fracture?

A

FOOSH - fall onto outstretched hand

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16
Q

What sign might be present on palpation of the hand/wrist in a patient with a scaphoid fracture?

A

Tenderness in the anatomical snuffbox

17
Q

What is they key complication of a scaphoid fracture?

A

Avascular necrosis

18
Q

What is meant by the term pathological fracture?

A

A fracture which occurs as a result of underlying disease of the bone (e.g. osteoporosis, tumour/mets, Paget’s disease of the bone)

19
Q

What is the mnemonic to remember which cancers commonly metastasise to bone?

A

PoRTaBLe:

  • Prostate
  • Renal
  • Thyroid
  • Breast
  • Lung
20
Q

Which system can be used to classify paediatric growth plate fractures?

A

Salter-Harris classification

21
Q

Describe the Salter-Harris classification

A

Types I-V (remember using mnemonic SALTER)
I/S - Straight across (physis)
II/A = Above (physis and metaphysis)
III/L = Lower (physis and epiphysis)
IV/TE = Through Everything (physis, epiphysis and metaphysis)
V/R = cRush injury involving physis

22
Q

Ankle fractures involve either the… or the…

A
  • Medial malleolus (distal tibia)

- Lateral malleolus (distal fibula)

23
Q

Which classification system can be used to describe fractures of the lateral malleolus?

A

Weber classification

24
Q

Describe the Weber classification

A

This system describes the location of the fracture in relation to the distal syndesmosis (join) between the tibia and fibula

A = below the ankle joint (syndesmosis intact)
B = at the level of the ankle joint (syndesmosis may/may not be affected)
C = above the ankle joint (syndesmosis disrupted)
25
Q

A T-score between -1 and -2.5 means…

A

Osteopenia

26
Q

A T-score less than -2.5 means…

A

Osteoporosis

27
Q

A T-score less than -2.5 plus a fracture means…

A

Severe osteoporosis

28
Q

Which treatment can be used as an alternative form of bone protection in a patient who cannot tolerate a bisphosphonate

A

Denosumab (monoclonal antibody - inhibits osteoclast activity)

29
Q

Which rules are used to determine whether an ankle XR is indicated?

A

Ottowa ankle rules

30
Q

What are the Ottowa ankle rules?

A
  1. Inability to weight bear for four steps, OR
  2. Bone tenderness over medial malleolus, OR
  3. Bone tenderness over lateral malleolus
31
Q

Describe the management of a…

a) Displaced scaphoid fracture
b) Undisplaced scaphoid fracture

A

a) Screw fixation

b) Cast for 6-8 weeks

Orthopaedics (8 decks)

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