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Musculoskeletal > Fractures > Flashcards

Fractures Flashcards

1
Q

Displacement

A

Translation of the distal fragment

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2
Q

Description of displacement in the hand

A

Volar

Dorsal

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3
Q

Angulation

A

Bone is at an improper angle

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4
Q

Medial angulation

A

Varus

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5
Q

Lateral angulation

A

Valgus

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6
Q

Carpal bones
Proximal
(Ulnar > Radial)

A

Triquetrium
Pisiform
Lunate
Scaphoid

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7
Q

Carpal bones
Distal
(Ulnar > Radial)

A

Hamate
Capitate
Trapezoid
Trapezium

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8
Q

Management of displaced and angulated fracture

A

Reduction under anaesthesia

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9
Q

Management of unstable extra-articular diaphyseal fracture

A

Fixed with open reduction and internal fixation

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10
Q

Management of displaced intra-articular fractures

A

Fixed with open reduction and internal fixation

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11
Q

Vessels prone to injury in pelvic fracture

A

Internal iliac

Pre-sacral venous plexus

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12
Q

Lateral compression fracture of the pelvis

A

Fractures through the pubic rami/ischium

SI joint disruption

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13
Q

Vertical shear fracture

A

Occurs due to axial force on one hemipelvis

Hemiplevis displaced superiorly

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14
Q

Open Book Pelvis Fracture

A

Anteroposterior compression injury

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15
Q

Which way does the surgical neck of the humerus displace in fracture?
Why?

A

Medial displacement of shaft

Due to pectoralis major

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16
Q

Mx of minimally displaced humeral fractures

A

Conservatively

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17
Q

Mx of displaced humeral fractures

A

Usually settle once muscle spasm stops

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18
Q

Mx of persistently displaced fractures

A

Usually internal fixation

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19
Q

Clinical Features of Anterior Shoulder Dislocation

A

Arm held adducted
Loss of symmetry
Axillary nerve injury (regimental badge patch)

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20
Q

Management of Anterior Shoulder Dislocation

A

Closed reduction under sedation/anaesthesia

Placed in a sling for 2-3 weeks then physiotherapy

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21
Q

Posterior Shoudler Dislocation

  • Classic sign
  • Mechanism
A

Light bulb sign on x- ray

Mechanism: posterior force on adducted internally rotated arm

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22
Q

Sign of anterior shoulder dislocation

A

Detachment of anterior glenoid labrum = Bankart lesion

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23
Q

Types of injury to the acriomioclavicular joint

A

Sprain
Subluxed
Dislocated

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24
Q

Subluxation of AC joint

A

Acriomioclavicular ligaments are usually ruptured

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25
Q

Dislocated AC joint

A

AC ligaments and coracoclavicular ligaments also disrupted

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26
Q

Mx of AC joint injuries

A

Wear a sling for a few weeks

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27
Q

Mechanism of transverse and comminuted humeral shaft fractures

A

Direct trauma

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28
Q

Mechanism of oblique and spiral fractures

A

Fall +/- twisting injury

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29
Q

Angulation acceptable in humeral shaft fractures

A

30 o

Shoulder and elbow joint allow for this

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30
Q

Complication of humeral shaft fracture

A

Radial nerve Injury

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31
Q

Presentation of radial nerve injury

A

Wrist drop

LOS in the 1st web space

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32
Q

Management of humeral shaft fracture

A

IM nail

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33
Q

Mx of distal intra-articular humerus fracture

A

Open reduction and internal fixation

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34
Q

Olecranon Fracture

=

A

Fracture of the olecranon process of the ulna

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35
Q

Mechanism of olecranon fracture

A

Fall onto the elbow
WITH
Contraction of the triceps

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36
Q

Mx of Olecranon fracture

A

ORIF

If transverse, fix with wiring

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37
Q

Mechanism of radial head and neck fractures

A

FOOSH

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38
Q

Signs of undisplaced radial fracture

A

Fat pad on lateral x-ray

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39
Q

What does a fat pad suggest?

A

of 1+ bones at the elbow

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40
Q

Presentation of undisplaced radial head fracture

A

Lateral pain on supination/pronation

41
Q

Mx of minimally displaced and undisplaced radial head fractures

A

Conservatively - sling

42
Q

Mx of displaced radial head fractures

A

May require surgery

- IF fragments prevent full extension

43
Q

Which way does the elbow dislocate?

Mechanism?

A

Posterior

Mechanism: FOOSH

44
Q

Mx of uncomplicated elbow fracture

A

Closed reduction

Short period in sling

45
Q

Nightstick Fracture

A

= fracture of the ulnar shaft

46
Q

Mx of Nightstick Fracture

A

Conservatively

ORIF may improve return to function

47
Q

Mx of diaphyseal fracture of both bones in the forearm

A

ORIF

48
Q

Mx of minimally angulated fractures of both bones in the forearm
- Children

A

Plaster cast

- The bones remodel

49
Q

Mx of substantially angulated fractures of both arms in the forearm

A

MUA

50
Q

Monteggia Fracture Dislocation

Definition

A

MURD
Fracture of Ulna
Radial Head Dislocation

51
Q

Where does dislocation occur in Monteggia F-D?

A

Proximal head of the radius

52
Q

Management of Monteggia F-D

A

ORIF of the fracture

53
Q

Galeazzi Fracture Dislocation

Definition

A

GRUD
Fracture of the radius
Ulnar head Dislocation

54
Q

Where does the dislocation occur in Galeazzi F-D?

A

Distal radioulnar joint

55
Q

Investigation of Monteggi F-D

A

Forearm and elbow x-ray

56
Q

Investigation of Galeazzi F-D

A

forearm and lateral wrist x-ray

57
Q

Colles Fracture

A

= extra-articular fracture
Distal radius
Dorsal displacement

58
Q

Which way does the fracture displace in Colle’s?

A

Dorsally

59
Q

Complications of Colle’s fracture

A

Median nerve compression

60
Q

Mx of minimally displaced Colle’s fracture

A

Splint only

61
Q

Smith’s Fracture

A

= extra-articular fracture
Distal radius
Volar displacement

62
Q

Mx of Smith’s Fracture

A

ORIF with plates and screws

63
Q

Complications of Smith’s Fracture

A

Malunion

64
Q

Which way does a Smith’s fracture displace?

A

Volar

65
Q

Barton’s Fracture

A

= intra-articular
Distal radius
Dislocation of the radiocarpal joint

66
Q

Classification of Barton’s Fracture

A

Volar

Dorsal

67
Q

Mx of Barton’s Fracture

A

ORIF

68
Q

Mx of comminuted intra-articular distal radius fracture

A

External fixation

69
Q

Scaphoid fracture

  • Mechanism
  • Presentation
A

Mechanism: FOOSH

Tenderness in the anatomical snuffbox, pain compressing thumb metacarpal

70
Q

Investigation of scaphoid fracture

A

4 x-ray views

71
Q

Mx of scaphoid fracture

A

Plaster cast

72
Q

Complications of scaphoid fractures

A

Non-union

Avascular necrosis

73
Q

Perilunate dislocation

  • Definition
  • Mechanism
A

= dislocation of one of the carpal bones

Mechanism: hyperdorsiflexion

74
Q

Mx of perilunate dislocation

A

Emergency

Closed reduction and pinning

75
Q

Scaphoid Lunate Dissociation

- Sign

A

= scapho-lunate ligaments rupture

- See increased gap between scaphoid and lunate

76
Q

Mx of scaphoid lunate dissociation

A

Closed reduction
K wiring
+/- ligament repair

77
Q

Complications of femoral shaft fracture

A

Blood loss

Fat embolism

78
Q

Management of femoral shaft fractures

A

Resuscitation
Closed reduction
Stabilisation

79
Q

Distal femoral fracture

- Mechanism

A

Fall onto flexed position

80
Q

Position of distal fragment in distal femoral fracture

- Mechanism

A

Flexed position

Gastrocnemii pulls distal fragment into flexed position

81
Q

Mx of knee dislocation

A

EMERGENCY - high risk of vascular injury
Reduce urgently
NV assessment

82
Q

Which way does the patellar ‘nearly’ always dislocate?

A

Laterally

83
Q

Presentation of patellar dislocation

A

Pain over the medial retinaculum (tendon in knee)

May have haemarthrosis

84
Q

Mx of patellar dislocation

A

Temporary splintage

85
Q

Proximal tibial fracture

- Valgus stress

A

Causes lateral plateau fracture

86
Q

Direct blow in proximal tibial fracture

- Risk

A

Can cause proximal fibular fracture

Injury to the common fibular nerve

87
Q

Proximal tibial fracture

- Varus stress

A

Causes medial plateau fracture

88
Q

Mx of proximal tibial fracture

A

Fixation

89
Q

Mx of tibial shift fracture

- When non-operative?

A

Up to 50% displacement

5 o angulation

90
Q

Mx of tibial shaft fracture

- Operative

A

Internal fixation

- If comminuted usually require surgery

91
Q

Distal tibial fracture

A

= distal tibial extra-articular fracture

- In good position that can be treated conservatively

92
Q

Mx of more distal distal tibial fracture

A

Plating

93
Q

Mx of less distal distal tibial fracture

A

IM nail

94
Q

Pilon fracture

A

= intraarticular fracture of distal tibia, needs ORIF

95
Q

Why might an ankle fracture be unstable?

- Management

A

Rupture of the deltoid ligament

Mx: ORIF

96
Q

Criteria for assessing ankle fracture

A

Ottawa

97
Q

When to x-ray an ankle?

A

Severe localised bony tenderness
OR
Inability to weight bear 4 steps

98
Q

Signs of deltoid ligament rupture on ankle x-ray

A

Talar shift on AP x-ray

99
Q

Risk of calcaneal fracture

A

Compartment syndrome

Musculoskeletal (7 decks)

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