fractures Flashcards
CT vs MRI for fx
CT for pelvic, facial, intra-articular fx.
MRI for occult hip fx
antibx for open fx
1st and 2nd generation cephalosporins and aminoglycosides)
salter harris type I
epiphyseal plate
salter harris type II
epiphysis with metaphysis fragment
salter harris type III
fx through the epiphysis through the articular surface
salter harris type IV
fx through the distal metaphysis, epiphyseal plate, and epiphysis
what is a torus fx and tx
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
what is a greenstick fx and tx
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.
lisfranc fx
dislocation of the tarsometatarsel joint complex
common sites for dislocations
anterior shoulder, posterior hip, posterior elbow
what is the most common condition affecting the cervical spine.
spondylosis
most common fx in children
clavicle fracture
Fractured clavicle occurs how, look for what, xray, tx
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
humeral head fx. occur in who, PE, Xray, TX
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.
what should u do in a humeral head fx to prevent frozen shoulder
pendulum exercises with early mobilization
neer classification of humeral head fx
displaced fx are 2part, 3part, 4 part depending of fracture parts involved.
humeral head fx: look for injuries to what
brachial plexus and axillary artery
PE of humeral shaft fx
pain, swelling, deformity, shortening. look for radial nerve injury
xray, tx, complication of humeral shaft fx
AP and lateral of elbow and shoulder; coaptation splint. look for radial nerve injury
mechanism for a supracondylar fx
fall on outstrectched hand with hyperextension of elbow
why pay special attention with brachial artery
most spastic artery and can lead to Volkmann’s ischemic contracture
xray and tx for supracondylar fractures
AP and lateral. closed reduction with posterior splint application for displaced fx. ORIF in adults
complications in supracondylar humerus fx
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
tx of boxers fracture
25-30 degrees of angulation should be reduced with a ulnar splint and follow up in 1-2 wks
colles’ fracture
distal radius fracture with dorsal angulation. from fall onto dorsiflexed hand. cast immobilization after reduction
most common injury to the wrist
colles’ fracture
silver fork deformity
colles’ fracture
most common fracture of the elbow in adults
radial head fx
PE of radial head fx
pain over lateral aspect of elbow that worsens with foream rotation
kid with the extremity fully pronated, partially flexed, held tightly to the side
radial head fx
Dx of radial head fx
AP and lateral to establish diagnosis. CT to determine degree of comminution
how to reduce a radial head fracture
screwing motion to put radial head back into annular ligament
why is a scaphoid fx so important
radial artery is blood supply. proximal portion of navicular bone has poor blood suppy
scaphoid fx PE, xray
pain over snuffbox, swelling. scaphoid series, may repeated 2-3 wks later. may get bone scan/MRI
scaphoid fx tx
long arm thumb spica cast for displaced fx, short arm thumb spica cast for nondisplaced fx. A >1mm will need a ORIF
