Fractures Flashcards
If trauma is suspected how many views on x-ray should be requested?
At least 2
What additional view is required if an upper cervical spine injury is suspected?
Odontoid peg.
Patient opens mouth to see C1+C2
How many views are required for a ?scaphoid fracture?
4
Who is more likely to have a scaphoid fracture?
Young males
Why do fractures look black on x-ray?
Intra-cortical space fills with haematoma which is a soft tissue and shows up black
What are the five different types of fracture?
Oblique Transverse Spiral Comminution Longtitudinal
What other factors need to be commented upon on reading an xray?
?joint involvement
?angulation
?displacement
?impaction
What are sesamoid bones?
Extra-articular
Common in hands and feet.
Small bones, found with tendons
What is the most common type of glenohumeral dislocation?
Anterior dislocation (95%)
How would you tell if the radio-capitellar joint was displaced?
Draw a line down middle of radius and it should intersect capitellum
How could you tell if the humero-capitellar joint was displaced?
The medial side of the humerus should point down through the middle third of the capitellum
What is the posterior fat pad sign?
At the elbow the posterior fat pad will become displaced and can be seen posterior to distal humerus
What kind of fractures do children get and how are they seen?
Buckle fracture.
Look like a bump on the outside of the bone rather than a crack
What is a greenstick fracture?
Common in children.
Incomplete fracture, with only 1 side of the bone affected
What is NAI?
non-accidental injury
What are examples of a bony ring?
Pelvis
Forearm
Leg
Spinal canal
What is important to remember about bony rings?
A fracture in one place means there must be an abnormality in another
What kind of foreign materials can’t be seen on x-ray?
Plastic and wood.
Only metal and glass can be seen.
What is a Colles fracture?
Fracture in distal radius
shows a dinner fork abnormality
Where does a scaphoid fracture present its pain?
Anatomical snuffbox
What nerve can a #NOH damage?
Axillary
Where does a Bennett’s fracture occur?
Articular surface of first metacarpal base
What time scale should a hip fracture pt see orthopods?
within 4 hours
What time scale should hip fracture pts have surgery?
Within 48 hours
What analgesic can be given if pt is confused on morphine?
Oxycodone
Who is most likely to get proximal femur fractures?
Females, over 50 Osteoporotic Smokers Excess alcohol Impaired vision
Describe the blood supply to the femoral head
Mostly from medial circumflex femoral artery. Retinacular arteries arise from this.
Ligamentum teres supplies fovea
Why is AVN common in #NOF?
Femoral artery damage is common and it is the main blood supply.
What are the types of proximal femoral fracture?
Intracapsular
Extracapsular
What is Shenton’s line?
Should be a smooth (imaginary) line running from pubic ramus to the inferiomedial neck of the femur
What signs can be seen in #NOF?
Shortening
External rotation
How can the median nerve be assessed in children?
OK sign
How can radial nerve be assessed in children?
Thumbs up sign
How can ulnar nerve be assessed in children?
Starfish with fingers
True or False
Dependent on the patient’s age and co-morbidities fixing a hip fracture may be refused
False.
The complications of not fixing the fractures are worse than the operative complications.
How are intracapsular fractures fixed?
Hemi-arthroplasty or THR
How are extra-capsular fractures fixed?
Internal fixation
What is the risk with intra-capsular fractures?
AVN
non-union
How is an extra-capsular hip fracture treated?
Dynamic hip screw
