Fractures Flashcards
Most common shoulder dislocation
AnteriorInferiorPosterior
Management of shoulder dislocation
Reduction (with Hippocratic method)ImmobilisationRehab
What is a Colle’s fracture?
Caused by FOOSHDinner fork type deformityTypically: transverse fracture of radius 1-2 inch proximal to radio-carpal jointDorsal displacement + angulation
What is a Smith’s fracture?
Ventral angulation of distal radius fragment (garden spade deformity)Caused by falling backwards onto an outstretched palm with wrist flexed
What is a Barton’s fracture?
Distal radius fracture + associated radiocarpal dislocationResultant fragment tends to slip so fracture is unstable
What is an isolated radial styloid fracture?
Caused by falls onto outstretched hand or kickback injuriesSometimes called Hutchinson fracture
Grading of ankle sprains
1 = mild stretch of ligament without instability2 = partial rupture without instability3 = complete rupture with instability of joint
S+S of sprain vs strain
Sprain: pain, tenderness, swelling, bruising, functional lossStrain: pain, spasm, weakness, cramping, haematomas
What are the ottowa rules?
When to give ankle X rayPain in malleolar zone + 1 of the following:Inability to weight bearBone tenderness along distal portion of fibula or tip of lateral malleolusBone tenderness along distal edge of tibia or tip of medial malleolus
Management of ankle strain
ProtectionRest Ice Compression ElevationAvoid HARMHeat Alcohol Running Massage
Features of hip fracture
Common in elderly osteoporotic femalesPainShortened + internally rotated leg
Location of hip fractures
Intracapsular: edge of femoral head to insertion of capsule into jointExtracapsular: trochanteric or sub trochanteric
What is the Garden system?
Type 1: incomplete fracture - stable2: complete fracture but undisplaced3: complete + partially displaced4: complete + totally displaced
Management of intracapsular fracture
Undisplaced: internal fixation/ hemiarthroplastyDisplaced: reduced + internal fixationIf older: hemiarthroplasty or hip replacement
Management of extracapsular hip fracture
Dynamic hip screwIf reversible oblique, transverse or sub trochanteric: intramedullary device
What to assess for in ?wrist fracture
Neurovascular compromiseExamine joints above + below
Management of wrist fracture
Closed reductionTraction + manipulation under anaestheticRepeat Xray after 1 week to check for displacement - if displaced, surgical open reduction + internal fixation
Complications of wrist fracture
MalunionMedian nerve compressionOsteoarthritis
What are bony bankart lesions + Hill sachs defects?
Bankart = fractures of anterior inferior glenoid bone, seen with recurrent shoulder dislocationsHill-Sachs = impaction injuries to chondral surface of humeral head
X rays for shoulder dislocation
Should get ‘trauma series’ = AP, Y scapular + axial viewsLightbulb signs = posterior dislocation
What doesa Colles’ fracture indicate is underlying?
Osteoporosis
Describe the features of a scaphoid fracture
Tenderness in anatomical snuff box
Pain on scaphoid tubercle
Pain on axial loading
Management of scaphoid fracture
Postive x ray - thumb spica splint for 6-8 weeks, repeat x ray in 2 weeks
Negative x ray - thumb spica splint, repeat x ray in 1 week + CT scan
What is a calcneal fracture associated with?
Fall from height
Axial loading
When is a knee x ray required?
>55 y/o Tenderness at head of fibula Isolated tenderness of patella Inability to flex to 90 Inability to weight bear for 4 steps
What are high risk factors for infection of a wound?
Puncture wounds Crush injuries Wounds >12 hrs old Hand or foot wounds Age >50 Prosthetic joints/ valves Immunocompromised
What are bruises, abrasions + lacerations?
Non palpable bruise = ecchymosis
Palpable bruise = haematoma
Abrasion = partial to full thickness break in skin
Lacerations = wound produced from tearing of skin
Management of wounds
Disinfect skin Irrigate with saline Analgesia + anesthesia (7mg lidocaine w/ epinephrine or 5mg without) Evacuate hematomas Debride tissue Consider prophylactic abx Suture
