Fractures (core)

Question 1

What types of clavicle fractures are likely to be operated on?

Answer 1

Distal one third

Question 2

What are the Gustilo and Anderson classification for?

Answer 2

Open fracture severity

Question 2

What are the common fractures at the elbow in kids?

Answer 2

Lateral condyle

Pulseless supracondylar fracture

Question 3

In what position is a pulseless subcondylar fracture fixed?

Answer 3

Extension at elbow

Question 3

What is a galeazzi fracture?

Answer 3

Shaft of radius and dislocation of distal radioulnar joint

Question 4

What are the 4 steps to managing a fracture?

Answer 4

First aid

EMST/ATLS guidelines

Initial stabilisation - assessment, analgesia, prevent complications (reduction, splint, treat wound)

Definitive Management

Question 5

What are the Ottawa ankle rules? What are they for?

Answer 5

Tenderness over 6cm of the lower posterior border of the tibia, fibula or malleoli

Tenderness base of the 5th metatarsal

Tenderness of the navicular

Unable to fully weight bear

To determine whether an X-ray is required for an ankle injury

Question 6

What is the problem with displaced #NOF?

Answer 6

They have a higher rate of avascular necrosis

Question 8

What is a Colles fracture? When does it commonly occur?

Answer 8

Fracture of distal radius and ulna

Secondary to a FOSH

Question 8

What is a Barton’s fracture?

Answer 8

of distal radius

Question 9

What is a Weber fracture?

Answer 9

Fracture of the lateral malleolus of the fibula

Question 10

How do you communicate the details of a fracture?

Answer 10

Mechanism of injury

Fracture description

Displacement

Articular involvement

Soft tissue damage

Question 12

What are some clinical signs that are useful in assessing a pulseless subcondylar fracture?

Answer 12

Pulse

Sats

Colour

Cap refill

Question 14

What are the 3 rules for looking for elbow fractures

Answer 14

Look for fat pad posteriorly and anteriorly - indicative of damage

line through the Radial head points to the capitellum

Anterior humeral line dissects the centre of capitellum

Question 15

What is a Bowers fracture?

Answer 15

of 5th metacarpal

Question 16

How do you test the function of the radial, median and ulnar nerve?

Answer 16

Radial - “thumbs up”

Median - “ok sign”

Ulnar - “make a star”

Question 17

What is the rule of 2’s of xray?

Answer 17

2 views

2 joints

2 times

Question 18

What is the difficulty with humoral neck fractures?

Answer 18

The rotator cuff muscles can displacement the bone

Question 19

What are the rules for fracture healing times?

Answer 19

An UL fracture in kids takes 3-4 weeks to heal

LL limb fractures take double the time to heal

Adults take double the time to heal cf to kids

Question 20

What is a Monteggia fracture?

Answer 20

Dislocation of the proximal radioulnar joint in association with a fracture

Question 21

What is the difference between a subluxation and dislocation?

Answer 21

A subluxation is a partial dislocation

A dislocation is complete disruption of the joint

Question 22

What is a Biers’ block?

Answer 22

Use of a tourniquet to occlude outflow of the forearm and inject a large of ligocaine to anaesthetise the forearm

Question 23

In what planes does displacement occur?

Answer 23

Linear and rotational in the coronal and sagittal plane

Question 24

What is the immediate management of an open fracture?

Answer 24

ABCDE

Take picture

IM analgesia

Wash with copious amounts of saline

Reduce

Dress

Splint

Image

IV Abx and tetanus

Ortho referral

Question 25

What types of #NOFs are there?

Answer 25

Intracapsular

• Subcapital
• Transcervical
• Basicervical - base of femoral neck

Extracapsular