fractures

Question 1

CT vs MRI for fx

Answer 1

CT for pelvic, facial, intra-articular fx.

MRI for occult hip fx

Question 2

antibx for open fx

Answer 2

1st and 2nd generation cephalosporins and aminoglycosides)

Question 3

salter harris type I

Answer 3

epiphyseal plate

Question 4

salter harris type II

Answer 4

epiphysis with metaphysis fragment

Question 5

salter harris type III

Answer 5

fx through the epiphysis through the articular surface

Question 6

salter harris type IV

Answer 6

fx through the distal metaphysis, epiphyseal plate, and epiphysis

Question 7

what is a torus fx and tx

Answer 7

buckle fx. occurs when one side of the cortex buckles as a result of a compression injury.(falling on outstretched hand). 4-6 wks in cast

Question 8

what is a greenstick fx and tx

Answer 8

occurs in long bones with bowing. causes a break to one side of the cortex. angulation less then 15 degrees then long cast 4-6 wks; more then 15 degrees needs a referral.

Question 9

lisfranc fx

Answer 9

dislocation of the tarsometatarsel joint complex

Question 10

common sites for dislocations

Answer 10

anterior shoulder, posterior hip, posterior elbow

Question 11

what is the most common condition affecting the cervical spine.

Answer 11

spondylosis

Question 12

most common fx in children

Answer 12

clavicle fracture

Question 13

Fractured clavicle occurs how, look for what, xray, tx

Answer 13

fall on outstretched hand, look for brachial plexus injuries, AP view xray, tx is a figure 8 sling 4-6 wks in kids and 6 wk sling for adult

Question 14

humeral head fx. occur in who, PE, Xray, TX

Answer 14

fx of proximal humerus occur in older pts with OP. female 2:1, pain swelling tenderness of greater tuberosity, AP Lateral Y view are diagnostic., CRIF iwth velpaeus sling for nondisplaced.

Question 15

what should u do in a humeral head fx to prevent frozen shoulder

Answer 15

pendulum exercises with early mobilization

Question 16

neer classification of humeral head fx

Answer 16

displaced fx are 2part, 3part, 4 part depending of fracture parts involved.

Question 17

humeral head fx: look for injuries to what

Answer 17

brachial plexus and axillary artery

Question 18

PE of humeral shaft fx

Answer 18

pain, swelling, deformity, shortening. look for radial nerve injury

Question 19

xray, tx, complication of humeral shaft fx

Answer 19

AP and lateral of elbow and shoulder; coaptation splint. look for radial nerve injury

Question 20

mechanism for a supracondylar fx

Answer 20

fall on outstrectched hand with hyperextension of elbow

Question 21

why pay special attention with brachial artery

Answer 21

most spastic artery and can lead to Volkmann’s ischemic contracture

Question 22

xray and tx for supracondylar fractures

Answer 22

AP and lateral. closed reduction with posterior splint application for displaced fx. ORIF in adults

Question 23

complications in supracondylar humerus fx

Answer 23

Volkmann’s ischemic contractures and injuries to all 3 nerves! varus and valgus deformities of the elbow may arrest from the medial or lateral growth plate

Question 24

tx of boxers fracture

Answer 24

25-30 degrees of angulation should be reduced with a ulnar splint and follow up in 1-2 wks

Question 25

colles’ fracture

Answer 25

distal radius fracture with dorsal angulation. from fall onto dorsiflexed hand. cast immobilization after reduction

Question 26

most common injury to the wrist

Answer 26

colles’ fracture

Question 27

silver fork deformity

Answer 27

colles’ fracture

Question 28

most common fracture of the elbow in adults

Answer 28

radial head fx

Question 29

PE of radial head fx

Answer 29

pain over lateral aspect of elbow that worsens with foream rotation

Question 30

kid with the extremity fully pronated, partially flexed, held tightly to the side

Answer 30

radial head fx

Question 31

Dx of radial head fx

Answer 31

AP and lateral to establish diagnosis. CT to determine degree of comminution

Question 32

how to reduce a radial head fracture

Answer 32

screwing motion to put radial head back into annular ligament

Question 33

why is a scaphoid fx so important

Answer 33

radial artery is blood supply. proximal portion of navicular bone has poor blood suppy

Question 34

scaphoid fx PE, xray

Answer 34

pain over snuffbox, swelling. scaphoid series, may repeated 2-3 wks later. may get bone scan/MRI

Question 35

scaphoid fx tx

Answer 35

long arm thumb spica cast for displaced fx, short arm thumb spica cast for nondisplaced fx. A >1mm will need a ORIF