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Ortho > fractures > Flashcards

fractures Flashcards

1
Q

what type of fx is strait across?

A

transverse

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2
Q

what type of fx is diagonal?

A

oblique

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3
Q

what type of fx is in many pieces?

A

comminuted

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4
Q

what type of fx is two transverse fx’s?

A

segmental

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5
Q

what type of fx is rammed?

A

impacted

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6
Q

what is the other name for a buckle fx?

A

torus

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7
Q

what is the term for when a 2 fx pieces are spread apart farther than normal anatomy?

A

distracted

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8
Q

what is the term for one fractured piece that is shifted out of it’s anatomical plane?

A

displaced

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9
Q

what is the term for when a fractured piece is at a new angle?

A

angulated

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10
Q

what is the term for when a fractured piece has slid back over another?

A

shortening

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11
Q

What factors are prognostic indicators for good bone remodeling?

A

youth, proximity to the physis

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12
Q

what factors are poor prognostic indicators for less bone remodeling?

A

intra-articular, diaphyseal, malrotation

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13
Q

what is another term for the metaphysis?

A

“flare”

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14
Q

salter harris I

A

physis

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15
Q

salter harris II

A

metaphysis

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16
Q

salter harris III

A

epiphysis

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17
Q

salter harris IV

A

through both

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18
Q

salter harris V

A

crush

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19
Q

which salter harris is most likely to result in LLD, angular deformity, and significant LTD?

A

physeal

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20
Q

What is the weakest structure: ligaments, physes, or metaphyseal bone?

A

physes, especially in regards to torsional force

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21
Q

What fx’s should be raising red flags for abuse?

A

posterior ribs, sternum, multiple stages of healing

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22
Q

You are concerned for elbow fx. What are you looking at on your lateral xray?

A

Check that the anterior line of humerus and mid radius create 90 degree angles in the middle of capitellum.

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23
Q

FOOSH’ing children =

A

torus fx, need to be casted minimally for 4 weeks

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24
Q

Monteggia Fx:

A

Fx proximal ulna, radial head dislocation

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25
Q

Galeazzi Fx:

A

Fx distal radius, distal ulna dislocation

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26
Q

Peak incidence of scaphoid fx’s occurs in pt’s of what age?

A

late teens/early 20’s

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27
Q

Tx of non-displaced scaphoid fx

A

thumb spica

28
Q

tx of displaced scaphoid fx

A

screw fixation

29
Q

what artery is at greatest risk during scaphoid fx?

A

radial

30
Q

tx of proximal humerus fx

A

nonoperatively in sling

31
Q

Young patient thinks she sprained her ankle and is having ttp over lateral malleolus. Xray is normal. How do you treat?

A

As though it is physis fx, young rarely have sprain

32
Q

how do you tx JOne’s fx?

A

SLNWB x 6 weeks, then 4 wks, WB

33
Q

who gets Jone’s fx’s

A

teen athletes

34
Q

3 fx’s of 5th metatarsal:

A

1) Most proximal–avulsion of styloid
2) Jone’s
3) Stress

35
Q

Boxer fx get’s _____ cast x ____ weeks. Some angulation is ok, as long as it’s less than ___ degrees

A

ulnar gutter, 6 wks, <30 degrees

36
Q

imbalance b/t osteoclastic and osteoblastic activity causes:

A

stress fx

37
Q

what imaging is good for stress fx?

A

Xray, low threshold for MRI

38
Q

What type of femoral neck fx’s are stable?

A

compression

39
Q

What type of femoral neck fx’s need fixation?

A

tension

40
Q

Fx of the _________ most commonly leads to acute compartment syndrome

A

tibia (leading to anterior comp syndrome)

41
Q

5 P’s of compartment syndrome

A

1) pain
2) poikilothermia (cold)
3) pulselessness
4) pallow
5) paresthesia

42
Q

When testing compartment pressure using a Striker monitor, what is the criteria for compartment syndrome?

A

Diastolic - opening pressure. Anything less than 30mmHg requires fasciotomy

43
Q

When testing Neuro, an extended index finger proves intact fxn of the ________ nerve

A

radial

44
Q

A-Ok sign means the ____nerve is intact

A

median

45
Q

digit abduction means the _______ nerve is ok

A

ulnar

46
Q

shoulder abduction means the _______ nerve is ok

A

axillary

47
Q

dorsiflexion of foot means the ______ nerve is ok

A

peroneal

48
Q

plantar flexion of foot means the _______nerve is ok

A

gastroc

49
Q

contraction of the quads means the ________ nerve is ok

A

femoral

50
Q

When are you at highest risk for fat emboli?

A

12-72 hours s/p fx of LONGBONE

51
Q

What s/s are worrisome for fat emboli?

A

respiratory distress, CNS changes, petichiae

52
Q

How do you treat fat emboli?

A

support, corticosteroids

53
Q

hypercoagulability, endothelial damage, and stasis are a recipe for _________

A

Virchow’s triad: DVT

54
Q

healing of fx in non-anatomic position:

A

malunion

55
Q

wrist drop = ______nerve

A

radial

56
Q

What injuries are best tx’ed with a hard soled shoe?

A

toe fx, metatarsal fx

57
Q

what injuries are best tx’ed with a WB?

A

WB protects foot and ankle: Ankle sprain, foot fx, some metatarsal fx’s

58
Q

when do you use a long arm splint?

A

elbow injury, distal humerus fx, FA fx

59
Q

when do you use a sugartong?

A

prevent pronation/supination

60
Q

when do you use a short leg posterior splint?

A

ankle fx/dislocation, distal tib fx

61
Q

How long is the onset of pressure necrosis from a cast that is too tight?

A

2 hours

62
Q

What can be done about a cast that is too tight and risks compartment syndrome/pressure necrosis?

A

univalve = 30% pressure reduction

bivalve = 60% reduction

63
Q

Casting padding should be applied from distal or proximal end?

A

distal to proximal….with 50% overlap, using 2 layers

64
Q

If you have a displaced fx or dislocated joint, what is the big deal about reducing it?

A

MINIMIZE SOFT TISSUE COMPLICATIONS

65
Q

What is the major principle of a closed reduction?

A

reversing the mechanism of injury to restore anatomy

66
Q

A permanent flexion of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers, caused by obstruction of the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome.

A

Volkmann’s Contracture/vascular injury

Ortho (10 decks)

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