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FINALS > fractures > Flashcards

fractures Flashcards

1
Q

what are the main patterns of fracture?

A 
transverse
oblique
spiral 
communited 
segmental
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2
Q

when should antibiotic prophylaxis be started with a fracture?

A

within 3 hours of an open fracture

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3
Q

what is the empirical treatment for antibiotic prophylaxis?

A

IV co-amoxiclav and metronidazole

co-trimoxazole if allergic

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4
Q

what are early complications with fractures?

A

haemorrhage
infection/sepsis
compartment syndrome
nerve injury

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5
Q

what are late complications with fractures?

A

avascular necrosis
stiffness and decreased function
non-union/malunion
DVT and PE

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6
Q

what is compartment syndrome?

A

build up of pressure within the fascial compartments

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7
Q

in which fractures does compartment syndrome most commonly occur?

A

tibial shaft

supracondylar

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8
Q

what is the presentation of compartment syndrome?

A

swelling
out of proportion pain
pain on passive stretching
decreased temp and loss of pulses

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9
Q

what is a diagnostic presentation of compartment syndrome?

A

intra compartment pressure >40

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10
Q

how is compartment syndrome managed?

A

fasciotomy

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11
Q

what is a complication of compartment syndrome?

A

Volkmanns ischemic contracture –> hand bent up

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12
Q

what fractures are at risk of AVN?

A 
scaphoid
proximal talus 
head of humerus 
capitulum of humerus 
femoral condyles 
intra capsular femoral fracture
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13
Q

what are complications of a surgical neck of humerus fracture?

A

AVN

axillary nerve damage

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14
Q

what is seen with axillary nerve damage?

A

loss of sensation over the badge area (C5)

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15
Q

what are complications of a humeral shaft injury? what sign is seen?

A

damage to radial nerve

presents with wrist drop and loss of sensation first dorsal web space

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16
Q

what causes a humeral shaft injury?

A

RTA, FOOSH or hit with a bat

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17
Q

what is an olecranon fracture?

A

fall onto point of elbow with triceps contracted

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18
Q

what can result due to an olecranon fracture?

A

olecranon process avulsion

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19
Q

what occurs due to a radial head fracture?

A

loss of supination and pronation

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20
Q

what sign is seen on x-ray with a radial head fracture?

A

fat pad sign

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21
Q

what is a Monteggia fracture?

A

proximal fracture of ulnar with dislocation of radial head

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22
Q

what is a Galeazzi fracture?

A

radial fracture with distal dislocation of radioulnar joint

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23
Q

what is a Colles fracture?

A

FOOSH with wrist extension:
extra-articular fracture of the distal radius
transverse fracture
usually 1 inch from radiocarpal joint

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24
Q

what sign is seen with a Colles fracture?

A

dinner fork deformity

dorsal displacement of wrist

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25
Q

what complications can occur with a Colles fracture?

A

median nerve compression

extensor pollicis longus rupture

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26
Q

what is a smith fracture?

A

FOOSH with wrist flexed

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27
Q

what is the presentation of a Smith’s fracture?

A

volar displacement of wrist

28
Q

how are smith’s fractures managed and why?

A

ORIF

very unstable fractures

29
Q

what is Barton’s fracture?

A

intra-articular fracture of wrist

smith/colles with dislocation of radiocarpal joint

30
Q

what is a scaphoid fracture?

A

tenderness over anatomical snuffbox

31
Q

what is associated with a scaphoid fracture?

A

delayed presence of fracture on x-ray
requires 4 x-rays
non-union
AVN

32
Q

what is Bennet’s fracture and what causes it?

A

intra-articular fracture of 1st carpometacarpal joint (base of thumb)
caused by first fights

33
Q

what would be the leg presentation in a hip fracture?

A

shortened, adducted and externally rotated leg

34
Q

where do intracapsular fractures occur?

A

at the neck of femur within the boundaries of the joint capsule

35
Q

what is there a risk of in intracapsular hip fractures? and why?

A

AVN due blood supply being in area

36
Q

what is the management for intracapsular hip fracture?

A

older and reduced mobility -hemi/THR

if younger and fitter <70 - reduction and internal fixation

37
Q

what is an extra-capsular hip fracture?

A

fracture outside of the joint capsule

classified as either trochanteric or subtrochanteric (lesser trochanter the line)

38
Q

what is the management for extra-capsular fracture?

A

fixation with dynamic hip screw

if reverse oblique, transverse or subtrochanteric then IM nail

39
Q

what is the management for a femoral shaft fracture?

A

immediate stabilisation with a Thomas splint

closed reduction and IM nail for stabilisation

40
Q

what is a tibial plateau fracture?

A

proximal tibial fracture that involves the articular surface of knee joint

41
Q

what is associated with tibial plateau fracture?

A

lots of swelling
compartment syndrome
post traumatic OA

42
Q

what nerve can be injured with a tibial plateau fracture? what does it cause?

A

common peroneal nerve injury = foot drop

43
Q

what type of injury causes a tibial shaft fracture?

A

sudden deceleration

44
Q

how is tibial shaft fracture managed?

A

conservatively managed but has slowest healing time

45
Q

what is a pilon fracture?

A

distal tibial fracture that involves the articular surface of the ankle

46
Q

what is the mechanism of a pilon fracture?

A

high impact trauma due to fall from height

47
Q

how is a pilon fracture managed?

A

immediate external fixation

considered medical emergency

48
Q

what is a stable ankle fracture? how is it managed?

A

isolated distal fibular fracture with a minimally displaced medial malleolus fracture
conservatively

49
Q

what is an unstable ankle fracture? how is it managed?

A

distal fibular fracture with deltoid rupture and bi-malleloar fracture
instability results from asymmetric joint space due to shift of talus

50
Q

when do you x ray in ankle injury?

A

if pain in malleolar zone
can’t weight bear steps
tenderness over distal tibia
bone tenderness over distal fibula

51
Q

what is the mechanism of a 5th metatarsal injury?

A

inversion

52
Q

what is the mechanism of action of a Pott’s injury

A

eversion

53
Q

what is the most common site of a stress fracture in the foot?

A

2nd metatarsal shaft

54
Q

what is a Pott’s fracture?

A

bimalleolar ankle fracture

55
Q

what is the most common type of shoulder dislocation?

A

anterior

56
Q

what is the mechanism of an anterior shoulder dislocation?

A

excessive external rotation or fall backwards

57
Q

what is the presentation of an anterior shoulder dislocation?

A

arm help in adduction

loss of sensation over badge patch area

58
Q

what is the management for shoulder dislocations?

A

closed reduction under sedation with sling to immobilise

59
Q

what is the mechanism of a posterior shoulder dislocation?

A

fall onto internally rotated arm

direct blow to anterior shoulder

60
Q

what is seen on x-ray of posterior shoulder dislocation?

A

light bulb sign

61
Q

in which direction is hip dislocation most common?

A

posterior

62
Q

what is the presentation of a posterior hip dislocation?

A

shortened leg, adducted and internally rotated

63
Q

what is the presentation of an anterior hip dislocation?

A

unshorted leg, abducted and externally rotated

64
Q

what can be damaged with hip dislocation?

A

sciatic nerve

65
Q

what is the management for hip dislocation?

A

ABCDE

reduction under GA

FINALS (25 decks)

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