Fractures/Dislocations Flashcards

1
Q

how to classify fractures?

A

location, direction, alignment, open vs closed, and dislocation

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2
Q

location?

A

proximal, middle, distal third

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3
Q

transverse break

A

right angle to the axis of the bone

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4
Q

spiral

A

bone has twised appearance, also called torsion

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5
Q

obliue

A

fracture line bw horizontal and vertical direction

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6
Q

comminuted

A

splintered or crushed

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7
Q

segmental fracture

A

two plus fracture that isolate a segment of the bone

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8
Q

Imaging studies for fractures

A

plain films (AP and lateral)

radionucleotide bone scanning= increased uptake at the side of an occult fracture or stress fraction (think athletes and disuse osteopenia)

CT- dx of pelvic, facial, or intra-articular fracture

**MRI sudy of chioce to dx an occulte hip fracture

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9
Q

treatment of an open fracture

A

**any bleeding should be considered an open frx until proven otherwise

-debride and irrigate in OR w/in 4-8 hours of injur

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10
Q

what abx for open fracture?

A

1/2 cd gen cephlosporin and aminoglycosids (48 hrs after frx and 48 hrs after surgery)

tetanus status!!!

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11
Q

tx of intra-articular frx

A

frx line enters a joint cavity

-open tx may be indicated to restore and maintain articular congruity

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12
Q

femur frx

A

percutaneous screws or hemiarthroplasty,

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13
Q

femur shaft frx tx

A

intramedullary rods or plates

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14
Q

intertrochanteric frx tx?

A

sliding hip screw fixation or long gamma nail

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15
Q

complication of femur frx?

A

potential to hemorrhage

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16
Q

tibia and fibula frx in adults

A

associated w./ ligamental, meniscal, and vascular injuries

17
Q

tibia and fibula simple frx

A

closed reduction w. cast placement

18
Q

complicated or unstable frx

A

open reduction internal fixation

19
Q

what part of children’s bones are most susceptible to frx than injury to attached ligments?

A

the physis

20
Q

what is a common finding ina ped fracture

A

swelling and tenderness over the physis

21
Q

what is helpful when evaluating a kids frx?

A

comparison filsm

22
Q

imcomplete frx

A

torus or greenstick

23
Q

torus fracture

A

• Occur when one side of the cortex buckles as a result of compression injury (e.g. FOOSH). Differs from a greenstick fracture by the mechanism of injury and sometimes buckles on both sides of the bone. Treatment is 4-6 weeks in a cast.

24
Q

greenstick

A
  • Occur in long bones when bowing causes a break in one side of the cortex.
  • When the angulation of the fracture is less than 15 degrees, a long arm or leg cast can be applied for 4-6 weeks.
  • Fractures with angulation of >15 degrees needs referral to orthopedic surgeon.
25
Q

when to worry about pt safety

A

radiographs of a young child show multiple fractures at various stages of healing, abuse should be suspected and the child referred to a protective agency

26
Q

dislocation

A

total loss of congruity that occurs between the articular surfaces of the joint

27
Q

subluxation

A

any less serious loss of congruity, or a less than complete dislocation

28
Q

common sites of dislocation

A

anterior shoulder, posterior hip, posterior elbow

less common-navicular and subtalar joints, as a combo of Lisfranc frx and second metatarsal joint

29
Q

Lisfranc joint

A

is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus.[

30
Q

tx of dislocation or subluxation

A
  • most able to be treated w/ a closed reduction
  • some reduce spontaneously, but require immobilization for 2-4 wks, followed by ROM acivity and return to nrmal activity
31
Q

what is important to do when tx dislocation /subluxat?

A

to assess neurovascular status pre- and postreduction as well as get postreduction radiographs to assure adequate reduction.

32
Q

strain

A

an injury to the bone-tendon unit at the myotendinous junction or the muscle itself

33
Q

sprain

A

involves collagenous tissue, such as ligaments or tendons

34
Q

CF of a strain or sprain

A

-often follows a sudden stretch

35
Q

complication ofa strain or sprain

A

avulsion of tendon (e.g. mallet finger avulsion or stretch of the terminal extensor tendon, which is treated with extensor splinting for 6 weeks)

OR

ligamentous sprain (e.g. stretch of the anterior talofibular ligament, which causes the common ankle sprain)

36
Q

TX of strain or sprain

A

supportive, RICES