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MSK > Fractures & Dislocations > Flashcards

Fractures & Dislocations Flashcards

1
Q

Fracture of the distal third of ulna is AKA

A

Colles fracture

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2
Q

What’s the X-ray abnormality associated with a Colles’ fracture?

A

Dinner-fork abnormality

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3
Q

Describe a communited fracture

A

Break or splintering of bone into more than 2 segments

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4
Q

Which fracture presents a particular risk of compartment syndrome?

A

Tibial fractures

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5
Q

Non-angulated, oblique tibial fractures around the diaphysis are best treated with which method?

A

IM nailing

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6
Q

What’s the emergency care for femur fractures?

A

Thomas splinting

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7
Q

Humeral shaft fractures present particular risk to which nerve & how does this commonly present if damaged?

A

Radial nerve & wrist drop

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8
Q

What’s more common - anterior or posterior shoulder dislocation?

A

Anterior

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9
Q

Damage to the axillary nerve is a common sequelae of anterior shoulder dislocation. What is the indicative sign?

A

Numbness in the regimental badge area

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10
Q

By definition, if the knee is dislocated, at least how many ligaments must be ruptured?

A

At least 3

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11
Q

Damage to the popliteal artery in knee dislocation is a surgical emergency. True/false?

A

True

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12
Q

Supracondylar fractures of the knee in children require what treatment?

A

Immediate reduction & pinning

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13
Q

Anterior shoulder dislocations are commonly managed how?

A

Closed reduction & sling 3 weeks

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14
Q

Which type of shoulder dislocation commonly presents from falling onto elbow?

A

Anterior dislocation

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15
Q

Detachment of the anterior labrum of the glenohumeral joint is termed what?

A

Bankart lesion

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16
Q

A shoulder injury where the glenoid labrum is detached AND the posterior humeral head is fractured is termed what?

A

Hill-Sachs lesion

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17
Q

Rotator cuff tears are common sequelae in Hill-Sachs lesions, true or false?

A

True

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18
Q

Re-dislocation of the shoulder is inversely proportional to age. True or false?

A

True - the younger you are the more likely to dislocate, the older the less likely to dislocate

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19
Q

If you’re <20 and dislocate your shoulder, what’s the chance of a re-dislocation?

A

80%

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20
Q

Is an X-ray required to confirm reduction in anterior shoulder dislocation?

A

Yes

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21
Q

Describe a neuropraxia: severity, duration, pathophysiology (3)

A

1) Mildest form of nerve injury 2) Usually lasts <28 days (if more, consider a axontomesis) 3) Myelin sheath intact, caused by crushing damage leading to a block without degeneration

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22
Q

Which manoeuvre is useful in closed reduction of shoulder dislocation?

A

Kocher

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23
Q

Posterior shoulder dislocation commonly results from what injury?

A

A posterior force applied on an ADDUCTED and INTERNALLY ROTATED shoulder

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24
Q

What’s the x-ray sign associated with posterior shoulder dislocation?

A

Light bulb sign

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25
Q

Posterior shoulder dislocation is treated how?

A

Closed reduction & sling with physiotherapy

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26
Q

Axillary nerve injury is commonly associated with loss of power in which muscle?

A

Deltoid

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27
Q

Describe an axonotmesis

A

Loss of myelin and Wallerian degeneration of nerve. Recovery is possible without surgery (1mm per day).

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28
Q

Describe a neurotmesis

A

Most severe form of nerve injury - when the nerve has been wholly transected

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29
Q

A fall onto shoulder commonly results in which joint dislocating?

A

AC joint

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30
Q

If the AC joint is only mildly displaced, how is it managed?

A

Conservatively

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31
Q

Anterior or posterior SC joint dislocation is more serious?

A

Posterior - can compress trachea (worry about dyspnoea, dysphagia, venous congestion)

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32
Q

A pure elbow dislocation (no fracture) requires what treatment?

A

Reduction and casting for 1 week, followed by physio

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33
Q

Galeazzi fracture is of…

A

Radius fracture, ulnar dislocation (GRUsome)

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34
Q

Monteggia fracture is of…

A

Ulnar fracture with radial head dislocation (MURder)

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35
Q

Which dislocation is common in cricketers?

A

Dorsal PIPJ

36
Q

Dorsal PIPJ dislocation is best treated how?

A

Immediately with reduction on pitch (common in cricketers) under a LA

37
Q

Finger dislocation is long-term managed how?

A

Splintage for 3 weeks

38
Q

High energy hip dislocation is associated with posterior/anterior wall acetabulum fracture?

A

Posterior

39
Q

Femoral head avulsion fractures require emergency reduction, true or false

A

True

40
Q

What are the complications of hip fracture (2)

A

1) AVN of femoral head 2) Hetertropic ossification

41
Q

Hip dislocation presents a risk to which nerve?

A

Sciatic nerve

42
Q

Patellar dislocation commonly occurs toward which side?

A

Laterally from a sudden quadriceps contraction with or without direct blow to patella

43
Q

An osteochondral fracture of the patella gives a risk of what, visible on X-ray?

A

Lipohaemarthrosis within joint

44
Q

Predisposing factors to patellar dislocation include (6)

A

1) Female 2) <20 yo 3) Ligamentous laxity 4) Genu valgum 5) Shallow trochela 6) Femoral neck anteversion

45
Q

Treatment for patellar dislocation (3)

A

1) Reduction 2) Splintage for 3 weeks 3) Physio

46
Q

Which nerve can be injured in knee injury?

A

Common fibular nerve

47
Q

Subtalar dislocations frequently occur toward which direction?

A

Median side

48
Q

Subtalar fractures are treated how?

A

Casting for 3 weeks

49
Q

What’s serious complication of subtalar fractures?

A

Fracture of talar neck AKA “aviators astragalus” (high risk of AVN)

50
Q

A Lisfranc fracture dislocation is technically what dislocation

A

Tarso-metatarsal dislocation

51
Q

Lisfranc injuries commonly result while foot is what?

A

Rotated while hyperplantarflexed

52
Q

Lisfranc injuries are treated how?

A

Internal fixation

53
Q

Can neurotmesis recover without surgery?

A

No

54
Q

“Nerve axon dies distal to injury” describes what type of injury & degeneration?

A

Axonotmesis and “Wallerian degeneration”

55
Q

What % of function is expected to return from patients who suffered an axonotmesis injury?

A

70-80%

56
Q

Describe the EARLY and systemic complications of any fracture (4)

A

1) Hypovolaemia 2) Fat embolism 3) ARDS / SIRS 4) MODS

57
Q

Atrophic non-union of bone is commonly due to which factors (3)

A

1) Lack of nutrition (e.g. smoking) 2) Reduction in blood supply 3) Fracture gap too big to repair

58
Q

Which drugs can cause atropic non-union? (3)

A

1) NSAIDs 2) Steroids 3) Bisphosphonates

59
Q

Malunion is technically defined as….

A

When a fracture heals in a non-anatomic position sufficient to cause symptoms

60
Q

Primary bone healing occurs when bone is…

A

Able to fill gap (often minimal gap, <1mm)

61
Q

Secondary bone healing fills the gap in bone initially with X then Y, then Z.

A

X = Granulation tissue Y = Cartilage Z = Bone

62
Q

Label the fracture types

A

A = Transverse

B = Oblique

C = Spiral

D = Communited

E = Segmental

63
Q

In fracture, angulation is reported according to the distal/proximal segment?

A

Distal

64
Q

Describe this fracture in terms of angulation & displacement?

A

Lateral displacement (around 50%) and lateral angulation (around 45 degrees)

65
Q

If a fracture is extra-articular, with minimal displacement, how is it best managed?

A

Conservatively (splintage)

66
Q

Which surgical fixation is contraindicated in significant soft-tissue swelling?

A

ORIF

67
Q

Do all intra-articular fractures require surgical stabilisation?

A

No. Undisplaced, intra-articular fractures may be stable and treated non-operatively

68
Q

How are displaced, intra-articular fractures managed?

A

Urgent reduction and internal fixation to prevent OA

69
Q

Which procedure is done to treat compartment syndrome?

A

Fascicotomy

70
Q

Unstable femoral shaft fractures are surgically stabilised using which method?

A

IM nail

71
Q

What are the risks associated with femoral shaft fracture? (2)

A

1) Blood loss (usually >1L)
2) Fat embolism

72
Q

Proximal tibial fractures are surgically managed how

A

Anatomical reduction & internal fixation

73
Q

Tibial shaft fractures are associated with what seriosu complication?

A

Compartment Syndrome

74
Q

A pilon fracture occurs where?

A

Distal tibia

75
Q

Bimalleolar fractures are treated surgically using which method?

A

ORIF

76
Q

Most proximal humerus fractures are caused by what?

A

Osteoporosis

77
Q

Distal humerus fractures generally require which surgical method to correct?

A

ORIF

78
Q

The radial head of the elbow is responsible for which movements of the arm?

A

Supination/ pronation

79
Q

“FOOSH” is a buzzword for which fracture?

A

Colles

80
Q

Complications of Colles’ fracture (4)

A

1) Median nerve injury
2) CRPS
3) Rupture of EPL
4) Loss of grip strength

81
Q

A minimally displaced Colles fracture is treated how?

A

Plastering

82
Q

A communited Colles’ fracture requires which surgical method to treat?

A

ORIF

83
Q

Smith’s fracture commonly results from falling onto what?

A

Back of hand

84
Q

Smith’s fracture is surgically treated how?

A

ORIF

85
Q

A Barton fracture is intra or extra-articular?

A

Intra-articular

86
Q
A

MSK (21 decks)

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