Fractures and Dislocations Flashcards
Knee Dislocation
Multiligament reconstruction
Physiotherapy
Shoulder dislocation
Acute: Closed reduction under anaesthetic, sling for 2-3 weeks
Severe acute: Open reduction
Chronic recurrence: Bankart procedure
Proximal Humeral Shaft Fracture
1/2 parts: Collar and cuff sling + analgesia, sometimes reduction
3 parts: ORIF
Distal Humeral Shaft Fracture
Cast, sling + analgesia
Nightstick Fracture
- Ulnar fracture
Conservative (Closed reduction, cast/splint +/- traction)
If necessary: ORIF
Monteggia Fracture
- Distal ulnar fracture
- Dislocation of the radial head at elbow
ORIF
Galeazzi Fracture Dislocation
- Radial fracture
- Dislocation of the ulna at distal radioulnar joint
ORIF
Reduce distal radioulnar joint
Colle’s Fracture
- FOOSH
- Distal radius- dorsal displacement
ORIF
Splintage
Smith’s Fracture
- FOITH
- Distal radius fracture- volar displacement
ORIF
Barton’s Fracture
- Intra-articular fracture of distal radius with dislocation of radial carpal joint
ORIF
Scaphoid Fracture
- FOOSH
- Pain in anatomical snuffbox
Minimally displaced: Cast immobilisation Disal fracture: 6-8 weeks Middle fracture: 8-12 weeks Proximal fracture: 12-24 weeks If blood flow is disrupted: ORIF
Intracapsular Hip Fracture
Hemiarthroplasty
THR
Extracapsular Hip Fracture
Compression/ dynamic hip screw
Tibial Shaft Fracture
Immediate: External fixation
Definite: Intramedullary nail
Minimally displaced (low impact): Closed, long leg cast
Crush Fracture
Analgesia
Balloon vertebroplasty
Metatarsal Fracture
6-12 weeks in a rigid soled boot
Open Fracture
Flucloxacillin, Gentamycin and Metronidazole
C-spine injuries
Firm cervical collar
Thoracolumbar spinal fractures
Pedicle screws
Fusion/ decompression
Low impact pelvic fracture
Fluid and blood resuscitation
Pelvic binder
Conservative management (closed reduction and cast)
Acetabular pelvic fracture
Fluid and blood resuscitation
Pelvic binder
Young: Reduction and rigid fixation
Old: THR
Acromioclavicular injury
Sling for a few weeks
Physiotherapy
Surgery if chronic pain
Proximal humerus fracture
Minimally displaced: sling and gradual mobilisation
Displaced: IF
AVN: Hemiarthroplasty
Humeral head fractures
Humeral brace
IF
Polytrauma: intramedullary nail
Olecranon fracture
- curved bony eminence of the ulna
ORIF
Radial head and neck fracture
Minimal: conservative
Displaced: ORIF
Elbow dislocation
Closed reduction, sling for 3 weeks + exercises
Both forearms fracture
ORIF
Unstable: MUA and cast
Very unstable: Flexible intramedullary nails
Metacarpal fractures
Neighbour strapping
K-wire stabilisation
Scapholunate dislocation
Closed reduction and K-wires
Phalangeal fractures
Neighbour strapping
K-wires / small screws
Peri-lunate dislocation
Reduction
Percutaneous pinning
Decompression (carpal tunnel)
Mallet finger
- DIP splint (>4weeks)
Ankle fracture
Stable: walking cast/ boot 6 weeks
Unstable: Reduction and internal fixation
Bimalleolar fractures
ORIF - wait 2 weeks for swelling to reduce
Foot fractures
ORIF
Toe dislocations
Closed reduction and neighbour strapping/ wiring
Top fractures
1st: Fixed
2-5th minimal: cast
2-5th displaced: k-wires
