fractures Flashcards

1
Q

compartment syndrome cause

A

develops due to build up of pressure within the fascial compartments

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2
Q

compartment syndrome presentation

A
  • swelling
  • out of proportion pain
  • pain on passive stretch
  • decreased temperature
  • loss of pulses
  • intra-compartment pressure > 30 mmHg
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3
Q

compartment syndrome management

A

fasciotomy

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4
Q

complication of compartment syndrome

A

Volkmann’s ischaemic contracture

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5
Q

Volkmann’s ischaemic contracture cause

A

due to failure to treat compartment syndrome resulting in muscle necrosis and fibrosis

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6
Q

fractures especially at risk of avascular necrosis

A
  • scaphoid
  • proximal talus
  • head of humerus
  • femoral condyles
  • intra-capsular femoral head
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7
Q

what is a surgical neck of humerus fracture

A

fracture of ulna and dislocation of radial head at elbow joint

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8
Q

surgical neck of humerus fractures are most common in

A

elderly patients with osteoporosis

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9
Q

surgical neck of humerus fracture associations

A
  • avascular necrosis
  • axillary nerve damage (presents with loss of sensation over badge patch area i.e. C5)
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10
Q

surgical neck of humerus fracture management

A
  • most commonly managed conservatively
  • open reduction and internal fixation of ulna
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11
Q

mechanism of humeral shaft fracture

A

fall on outstretched hand

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12
Q

humeral shaft fracture association

A

radial nerve damage (presents with wrist drop and loss of sensation in dorsal first web sapce)

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13
Q

humeral shaft fracture management

A

conservative (traction brace)

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14
Q

mechanism of olecranon fracture

A

fall onto point of elbow, with triceps contracted

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15
Q

olecranon fractures result in

A

avulsion of olecranon process

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16
Q

radial head fractures result in

A

loss of pronation and supination

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17
Q

radial head fracture associations

A
  • elbow dislocation
  • fat pad sign on x-ray
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18
Q

radial head fracture management

A

conservative

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19
Q

what is a Galeazzi fracture

A

radial head fracture with ulnar dislocation

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20
Q

what is a Monteggia fracture

A

ulnar fracture with radial dislocation (more common)

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21
Q

mechanism of a Colles fracture

A

fall on outstretched hand with wrist extension

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22
Q

what is a Colles fracture

A

extra-articular fracture of the distal radius with dorsal displacement (broken end of bone points back)

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23
Q

Colles fracture presentation

A

dorsal displacement and angulation of the wrist (dinner fork deformity)

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24
Q

Colles fracture associations

A
  • median nerve compression
  • extensor pollicus longus rupture
  • Sudecks dystrophy
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25
Q

mechanism of Smith’s fracture

A

fall on outstretched hand with wrist flexion

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26
Q

what is a Smith’s fracture

A

extra-articular fracture of the proximal radius with volar displacement (broken end of bone points forwards)

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27
Q

Smith’s fracture presentation

A

volar displacement and angulation of the wrist

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28
Q

Smith’s fracture management

A

open reduction and internal fixation (unstable fracture)

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29
Q

what is a Barton’s fracture

A

intra-articular fracture of the wrist

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30
Q

Barton’s fracture associations

A

subluxation of the carpal bones

31
Q

scaphoid fracture presentation

A

tenderness over anatomical snuffbox

32
Q

scaphoid fracture associations

A
  • delayed presence of fracture on x-ray
  • non-union
  • avascular necrosis
33
Q

mechanism of Boxer’s fracture

A

punching injury

34
Q

what is a Boxer’s fracture

A

5th metacarpal fracture

35
Q

Boxer’s fracture management

A

strap pinkie to adjacent finger

36
Q

hip fracture presentation

A
  • immobilisation and unable to weight bear
  • severe pain in hip, groin and knee
  • pain on palpation of greater trochanter and rotation of hip
  • shortened, adducted and externally rotated leg
37
Q

hip fracture diagnosis

A

x-ray (break in Shenton’s line visible)

38
Q

what is an intracapsular hip fracture

A

fracture that occurs at the neck of the femur within boundaries of joint capsule

39
Q

classification used for hip fractures

A

Garden classification

40
Q

what is a garden stage 1 hip fracture

A

undisplaced and incomplete

41
Q

what is a garden stage 2 hip fracture

A

undisplaced and complete

42
Q

what is a garden stage 3 hip fracture

A

complete fracture, but incompletely displaced

43
Q

what is a garden stage 4 hip fracture

A

complete fracture, completely displaced

44
Q

intracapsular hip fracture associations

A
  • non-union
  • avascular necrosis
45
Q

intracapsular hip fracture management

A
  • arthroplasty (standard management)
  • total hip replacement (better results, but higher risk of dislocation)
  • hemi-arthroplasty for less mobile patients
  • consider fixation in patients < 60
46
Q

what is a extracapsular hip fracture

A

fracture that occurs outside of the joint capsule and that can be classified as trochanteric or subtrochanteric

47
Q

extracapsular hip fracture associations

A
  • malunion
  • non-union
48
Q

extracapsular hip fracture management

A

fixation with dynamic hip screw of intramedullary nail

49
Q

mechanism of femoral shaft fracture

A

high energy fall

50
Q

femoral shaft fracture associations

A
  • substantial blood loss
  • acute respiratory distress syndrome due to fat embolism
51
Q

femoral shaft fracture management

A
  • immediate stabilisation with Thomas splint
  • closed reduction and IM nail for stabilisation
52
Q

what is a tibial plateau fracture

A

proximal tibial fracture that involves the articular surface of the knee joint

53
Q

tibial plateau fracture associations

A
  • lots of swelling
  • compartment syndrome
  • common peroneal injury (foot drop)
54
Q

tibial plateau fracture: management

A

may need external fixation prior to internal fixation

55
Q

mechanism of tibial shaft fracture

A

rotation forces of compression from sudden deceleration

56
Q

tibial shaft fracture associations

A

compartment syndrome if open fracture

57
Q

tibial shaft fracture management

A
  • conservative
  • slowest healing fracture
58
Q

mechanism of distal tibial fracture

A

rotation forces of compression from sudden deceleration

59
Q

distal tibial fracture management

A

conservative

60
Q

mechanism of pilon fracture

A

high impact trauma due to fall from height

61
Q

what is a pilon fracture

A

distal tibial fracture that involved the articular surface of the ankle

62
Q

pilon fracture management

A
  • surgical emergency
  • external fixation asap
63
Q

mechanism of ankle fracture

A

inversion or rotational forces

64
Q

ankle fracture presentation

A

inability to weight bear

65
Q

what is a stable ankle fracture

A

isolated distal fibular fracture minimally displaced medial malleolus

66
Q

what is an unstable ankle fracture

A

distal fibular fracture with deltoid rupture and bimalleolar fracture

67
Q

stable ankle fracture management

A

conservative

68
Q

unstable ankle fracture management

A

open reduction and internal fixation

69
Q

classification used for ankle fractures

A

Weber classification

70
Q

what is a Weber A ankle fracture

A

below the syndesmosis (usually stable)

71
Q

what is a Weber B ankle fracture

A

at the level of the syndesmosis (can be stable or unstable)

72
Q

what is a Weber C ankle fracture

A

above the syndesmosis

73
Q

mechanism of a 5th metatarsal fracture

A

inversion injury and avulsion of the insertion of peroneus brevis

74
Q

5th metatarsal fracture management

A

moon boot