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MSK SOH > Fractures > Flashcards

Fractures Flashcards

1
Q

Open fracture

A

Open wound

Due to a spike of fractured bone puncturing the skin

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2
Q

Closed fracture

A

Skin is in tact

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3
Q

Displacement

A

Direction of translation of the DISTAL fragment

- can be described as medially/laterally/anteriorly/posteriorly displaced

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4
Q

Displacement terms in the hand and forearm

A

Direction of translation of the DISTAL fragment

- can be described as ulnar/radial/volar/dorsal displacement

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5
Q

Angulation

A

Direction which the distal fragment points towards and the degree of this deformity
- can be described as medially/laterally/anteriorly/posterior angulation

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6
Q

Angulation terms in the hand and forearm

A

can be described as ulnar/radial/volar/dorsal displacement

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7
Q

Angulation terms in the lower limb

A

Varus/valgus/anteriorly/posteriorly

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8
Q

Intra-articular fracture

A

Fracture extends into the joint

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9
Q

Extra-articular fracture

A

Fracture does not extend into the joint

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10
Q

Name the 5 fracture patterns

A 
Transverse
Oblique
Spiral
Comminuted
Segmental
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11
Q

Transverse fracture

A

clean fracture straight across horizontally

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12
Q

Oblique fracture

A

diagonal fracture (at an angle)

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13
Q

Spiral fracture

A

From twisting injuries

In an S shape

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14
Q

Comminuted fracture

A

Fracture with 3 or more fragments

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15
Q

Segmental fracture

A

Bone has fractured in 2 separate places

Very unstable

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16
Q

X ray

A

Usually need an AP and lateral view

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17
Q

CT

A

Can determine the degree of articular damage

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18
Q

MRI

A

Detects occult fractures (clinical suspicion of fracture but normal X-ray)

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19
Q

Primary bone healing

A

Minimal fracture gap and the bone simply fills the gap with new bone from osteoblasts

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20
Q

Secondary bone healing

A

Gap at the fracture site which needs to be filled temporarily (by cartilage) in order for new bone to be laid down

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21
Q

Initial fracture management

A

Analgesia (IV morphine)

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22
Q

Immediate management if there is obvious displacement / dislocation

A

IV morphine

Immediate reduction

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23
Q

Management of stable fractures

A

Non operative

  • splint
  • immobilisation (cast)
  • bracing
  • rehabilitation
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24
Q

Management of unstable fractures

A

Reduction under anaesthetic
Surgical stabilisation
- internal fixation
- external fixation

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25
Q

Unstable intra-articular fracture management

A

ORIF

- using plate and screws

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26
Q

Who gets traction?

A

Children

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27
Q

Examples of internal fixators

A

IM nail
Plate
Screws

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28
Q

Examples of external fixators

A

Pins which go through the skin and into the bone

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29
Q

Open fracture initial management

A 
Antiseptic dressing 
IV broad spectrum antibiotics
Surgical debridement ASAP
Removal of infected bone  
Internal or external fixation
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30
Q

Intra-articular fracture commonly causes which complication?

A

Post-traumatic osteoarthritis

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31
Q

C-spine clearing in a conscious and co-operative patient

A

X-ray and if this is clear then remove the C-spine collar

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32
Q

C-spine clearing in a trauma patient

A

X-ray

CT scan

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33
Q

What are the 3 different X-ray views required for C-spine fractures

A

AP view
Lateral view
Peg open mouth view

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34
Q

Examination required for pelvic fractures?

A

PR examination

- need to assess sacral nerve root function and look for the presence of PR blood

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35
Q

Pelvic fracture : Antero-posterior compression injury

A

Open book fracture

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36
Q

Pelvic fracture : Antero-posterior compression injury management

A

Prompt reduction

Pelvic binder

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37
Q

NOF fracture - features

A

Can’t weight bear
Shortening of affected limb
External rotation of affected limb

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38
Q

NOF fracture - complications

A

AVN

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39
Q

Intracapsular hip fracture

A

Fracture is within the capsule

Arterial supply to the femoral head could be disrupted if fracture is displaced leading to AVN

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40
Q

Intracapsular hip fracture - management in elderly

A

Hemi-arthroplasty
OR
Total hip replacement

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41
Q

Intracapsular hip fracture - management in young and active individual

A

Fixation

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42
Q

Extracapsular hip fracture

A

Fracture is outwith the capsule so the blood supply is still in tact. All will heal eventually

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43
Q

Extracapsular hip fracture - types (2)

A

Inter-trochanteric

Sub-trochanteric

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44
Q

Extracapsular hip fracture - management

A

Internal fixation

- hip screw (or IM nail)

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45
Q

Extracapsular hip fracture - management of a subtrochanteric fracture

A

Thomas’ splint
Analgesia
Intramedullary nail

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46
Q

Femoral shaft fracture - management

A

Analgesia
Thomas’ splint
Closed reduction
Internal fixation - IM nail

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47
Q

Distal femoral fracture - cause

A

Fall onto the flexed knee

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48
Q

Distal femoral fracture - management

A

Internal fixation

- plate and screws

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49
Q

What is a plataeu fracture?

A

Proximal tibial fracture

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50
Q

Proximal tibial fracture is an EXTRA/INTRA articular fracture?

A

INTRA-articular

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51
Q

Proximal tibial fracture - clinical features

A

Valgus stress

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52
Q

Proximal tibial fracture - investigations

53
Q

Proximal tibial fracture - management

A

Internal fixation

- plate and screws

54
Q

Tibial shaft fracture - stable - management

A

Above knee plaster cast

55
Q

Tibial shaft fracture - unstable - management

A

Internal fixation

- IM nail

56
Q

What is a pilon fracture?

A

Distal tibial fracture
(ankle fracture)
Emergency

57
Q

Distal tibial fracture is an EXTRA/INTRA articular fracture?

A

INTRA-articular

58
Q

Distal tibial fracture - investigation

59
Q

Distal tibial fracture - management

A

Urgent ORIF with plate and screws if no soft tissue swelling

If extensive soft tissue swelling, stabilise with external fixation then do internal fixation once soft tissues settle

60
Q

Ankle fractures - likely mechanism of injury

A

Twisting forces, twisting force on a planted foot

61
Q

Stable ankle fracture

A

Isolated distal fibular fracture

62
Q

Unstable ankle fracture

A

Distal fibular fracture with rupture of deltoid ligament (medial bruising) or bimalleolar fracture

63
Q

Stable ankle fracture - management

A

Walking cast / moon boot for 6 weeks

64
Q

Unstable ankle fracture - management

A

ORIF

- plate and screws

65
Q

Calcaneal fracture

A

Can be extra-articular or intra-articular (subtler joint)

66
Q

Calcaneal fracture - cause

A

Fall from height onto the heel

67
Q

Talar fracture (displaced) - management

A

Open or closed reduction and internal fixation

68
Q

Talar fracture (displaced) - complications

A

AVN

- as talus gets blood supply from distal

69
Q

Midfoot (lisfranc) fracture

A

Fracture of the base of the 2nd metatarsal

70
Q

Midfoot (lisfranc) fracture - clinical features

A

Grossly swollen
Bruised foot
Unable to weight bear

71
Q

Midfoot (lisfranc) fracture - management

A

Closed or open reduction with internal fixation

72
Q

Fracture of base of 5th metatarsal - management

A

Walking cast or moonlit for 4-6 weeks

73
Q

Where on the foot is a common site of a stress fracture?

A

2nd metatarsal

74
Q

Management of stress fracture

A

Cast until pain subsides

75
Q

Extra-articular OPEN fracture of the toe - management

A

Debridement

Stabilise with wires

76
Q

Dislocation of toes - management

A

Closed reduction and buddy strapping / wiring

77
Q

Humeral neck fracture - cause

A

FOOSH

Fall on to shoulder

78
Q

Humeral neck fracture - location

A

Surgical neck

79
Q

Humeral neck fracture - elderly - management

A

Conservative

- sling

80
Q

Humeral neck fracture - v displaced and young - management

A

Internal fixation

81
Q

Humeral neck fracture - complications

A

Brachial plexus injury
Axillary nerve injury
Avascular necrosis

82
Q

Humeral shaft fracture - displaced - management

A

Internal fixation

- IM nail

83
Q

Humeral shaft fracture - non-displaced - management

A

Functional humeral brace

84
Q

Humeral shaft fracture - complications

A

Radial nerve injury

- wrist drop and loss of sensation in first dorsal web space

85
Q

Olecranon fracture - cause

A

Fall onto point of elbow

86
Q

Olecranon fracture - management

A

ORIF

- plate and screws

87
Q

Radial head fracture - cause

88
Q

Radial head fracture - investigations

A

X ray

- if undisplaced this shows fat pad sign

89
Q

Radial head fracture - undisplaced - management

A

Fat pad sign on x-ray

Needs sling

90
Q

Radial head fracture - displaced - management

91
Q

Nightstick fracture - managemnt

A

Conservative

- sling

92
Q

Fracture of both radius and ulna - management

A

ORIF

- plate and screws

93
Q

Monteggia fracture dislocation

A

Ulnar fracture with radial head dislocation

94
Q

Monteggia fracture dislocation - management

A

ORIF of ulnar fracture

95
Q

Galeazzi fracture dislocation

A

Radial fracture with dislocation at distal ulna

96
Q

Galeazzi fracture dislocation - management

A

ORIF of radial fracture

97
Q

Colles fracture

A

Distal radius fracture

Dorsal displacement or angulation of distal fragment

98
Q

Colles fracture is INTRA/EXTRA articular?

A

Extra-articular

99
Q

Colles fracture - cause

A

FOOSH (with wrist extended)

100
Q

Colles fracture - who gets it

101
Q

Colles fracture - investigation

A

X-ray

- dinner fork deformity

102
Q

Colles fracture - minimally displaced/angulated - management

A

Plaster cast 6 weeks

103
Q

Colles fracture - displaced/unstable - management

A

Manipulation

104
Q

Colles fracture - complications

A

Carpal tunnel syndrome

- Median nerve compression

105
Q

Smiths fracture

A

Distal radius fracture

Volarly displaced or angulated

106
Q

Smiths fracture is INTRA/EXTRA articular?

A

EXTRA-articular

107
Q

Smiths fracture - cause

A

Fall onto the back of a flexed wrist

108
Q

Smiths fracture - management

A

ORIF

- plate and screws

109
Q

Bartons fracture

A

Disal radius fracture

Radio-carpal displacement

110
Q

Bartons fracture is INTRA/EXTRA articular?

A

Intra-articular

- i.e. it involves the wrist joint

111
Q

Bartons fracture - managemnt

A

ORIF

- plate and screws

112
Q

Scaphoid fracture - cause

113
Q

Scaphoid fracture - clinical features

A

Tenderness/pain in the anatomical snuff box

114
Q

Scaphoid fracture - investigation

A

X-ray

- 4 views required

115
Q

Scaphoid fracture with no x-ray findings - management

A

Wrist splint

116
Q

Undisplaced scaphoid fracture - management

A

Plaster cast

117
Q

Displaced scaphoid fracture - management

A

Compression screw

118
Q

Scaphoid fracture - complications

A

AVN

- scaphoid has a unique blood supply

119
Q

Boxers fracture

A

Fracture of the 5th MCP due to punching injury

120
Q

Boxers fracture - management

A

Buddy strapping the affected digit to the adjacent finger

121
Q

Lunate fracture

A

Anterior dislocation into the carpal tunnel compresses the median nerve

122
Q

Childhood fractures - supracondylar fracture of elbow cause

A

Trampoline

123
Q

Childhood fractures - supracondylar fracture of elbow clinical features

A

Can’t make OK sign with hand

124
Q

Childhood fractures - supracondylar fracture of elbow risks

A

Median nerve damage

Brachial artery damage

125
Q

Childhood femoral shaft fractures - management (child under )

A

Gallows traction

Hip Spica cast

126
Q

Childhood femoral shaft fractures - management (child 2-6)

A

Thomas splint

Hip Spica cast

127
Q

Childhood femoral shaft fractures - management (child 6-12)

A

Flexible IM nail

128
Q

Childhood femoral shaft fractures - management (child over 12)

MSK SOH (24 decks)

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