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Y2 MSK > Fractures & management > Flashcards

Fractures & management Flashcards

1
Q

How does a fractured hip usually present?

A

Pain in the hip, groin & knee Unable to weight bear Shortened and externally rotated leg

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2
Q

What will an X-Ray of a hip fracgure show?

A

A break in shentons line

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3
Q

what is the difference between an intra-capsular and extra-capsular fracture?

A

intracapsular = neck of femur and within the joint capsulre

extracapsular = fractures outside the joint capsule

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4
Q

What are the 2 types of extra-capsular hip fractures? How are they managed?

A

trochanteric and subtrochanteric

Dynamic hip screw and IM nail

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5
Q

Management of an intra-capsular hip fracture?

A

THR or hemiarthroplasty if patient was already immobile bc increased risk of dislocation in THR

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6
Q

What is the usual mechanism of injury in femoral shaft fractures?

A

High energy trauma e.g. RTA

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7
Q

What are 2 potential complications of femoral shaft fracture?

A

Substantial blood loss

Fat embolus

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8
Q

Management of femoral shaft fracture?

A

Thomas splint initially to stabilise

Closed reduction and IM nail

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9
Q

What is a tibial plataeu fracture and what can it present with/lead to?

A

Proximal tibial fracture involving the articular surface of the knee joint

Associations:

  • lots of swelling
  • compartment syndrome
  • common fibular nerve injury
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10
Q

What is the slowest healing fracture in the body?

A

Tibial shaft

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11
Q

What is the mechanism of injury in tibial shaft fractures?

A

Rotational forces +/- compression from sudden deceleration

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12
Q

Management of tibial plataeu and tibial shaft fractures?

A

Internal fixation

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13
Q

What is a pilon fracture and what is their mechanism of injury?

A

Distal tibial fracture involving articular surface of ankle

High impact fracture - fall from height

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14
Q

Management of pilon fractures?

A

External fixation ASAP

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15
Q

What is an avulsion fracture?

A

When a bit of bone is pulled away from the main bone by the muscles that attach to it

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16
Q

What is at risk in a supracondylar fracture?

A

Brachial artery

17
Q

What is Volkmann’s contracture?

A

complication of elbow fractures (usually in children) - contraction of the forearm muscles due to ischeamia following trauma

18
Q

What movements are affected in radial head fracture?

A

Loss of pronation and supination

19
Q

What is the difference between a Gellazi fracture and a Monteggia fracture?

A

Gellazi = radial fracture with ulnar dislocation

Monteggia = Ulnar fracture with radial dislocation

20
Q

What is a Colles fracture and what is a classic presentation?

A

fracture of the distal radius (not involving the wrist joint) due to FOOSH with wrist extended

Dinner fork deformity

21
Q

What structure is at risk in a Colles fracture?

A

Median nerve compression

22
Q

Management of a Colles fracture?

A

Reduction and cast

23
Q

What is a Smiths fracture?

A

Distal radial fracture (not involving wrist joint) - FOOSH with wrist flexed (opposite of a Colles fracture)

24
Q

Management of a Smiths fracture?

A

open reduction and internal fixation - v unstable fracture

25
Q

What is a bartons fracture?

A

Intra-articular fracture of the wrist

26
Q

What is compartment syndrome?

A

When bleeding from a fracture/swelling of muscles due to trauma increase the pressure in the limb compartment affected - will compress vasculature and nerves

27
Q

Symptoms of compartment syndrome?

A

More severe pain expected from injury alone

Swollen limb

Altered sensation

Extreme pain on passive stretching of the muscles in the affected compartment

28
Q

Management of compartment syndrome?

A

Immediate removal of cast/dressings

urgent fasciotomy

29
Q

Fractures of the distal radius that heal in malunion can result in reduced grip strength, is this due to loss of flexion or extension at the wrist?

A

Extension (try to make a fist without extending wrist - not as strong)

30
Q

What nerve is at risk in a humeral shaft fracture?

A

Radial nerve

31
Q

What nerve is at risk in anterior dislocation of the shoulder?

A

Axillary nerve

32
Q

What nerve is at risk in colles fractures?

A

Median nerve

33
Q

What nerve is at risk in supracondylar fracture of the humerus?

A

Median nerve

34
Q

Give 4 risk factors for a proximal femoral fracture?

A

Osteoporosis (3x more common in females)

Smoking

Malnutrition

Excess alcohol

35
Q

What is the management of fractured femoral shafts in children under 3 and why is it different to adult management?

A

Traction - stops the muscles going into spasm and pulling the bone segments away

Y2 MSK (35 decks)

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