fractures: specific injuries Flashcards by Rose Richmond

what bones form the pelvis

sacrum, ilium, ischium, pubic phones

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what causes open book pelvis fractures

anteroposterior compression –> pubic symphysis splits

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blood supply to pelvis

internal iliacs and sacral venous plexus

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symptoms hip fracure

shortened and externally rotated leg

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classification for hip fractures

gardner: I = stable fracture that impacts valgus // II = complete but undisplaced fracture // III = displaced with some bony contact // IV = no bony contact

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mx undisplaced intracapsular hip fracture

internal fixation (or THR if unfit)

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mx displaced intracapsular hip fracture

THR or hemiplasty

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mx extracapsular hip fractures

stable trochanteric fracture = hip screw // oblique, transverse or subtronchateric = intremedullary device

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most common direction for hip dislocation

posterior

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posterior hip dislocation symtpoms

shortened leg, adducted, internally rotated

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anterior hip dislocation symptoms

not shortened, abducted and externally rotated

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mx hip dislocation

MUA within 4 hrs to prevent AVN

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complications hip dislocation

sciatic or femoral nerve injury, AVN, OA, dislocation

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mx femoral shaft break

closed reduction + intramedullary nails

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mechanism of patella fractures

direct eg dashboard injury // indirect eg quads contracts too hardly

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symptoms patella fracture

significant bruising and swelling, palpable gap, straight leg test

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invx patella fracture

2 planes of xray –> skyline

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mx patella fracture

undisplaced + intact extensor mechanism = 6 weeks brace + fully weight bear // displaced = consider operative

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mx proximal tibia fracture

intra-articular –> ORIF + plates and screws

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ottawa rules ankle injury

xray if pain over malleos + one of: bony tenderness on lateral or medial malleoulus, cannot weight bear

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weber classification for ankle breaks

A = below syndemosis // B = level of tibieal plafond // C = above syndemosis

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what is a maisonnoivre fracture

spiral tibial fracture –> wide ankle joint + disruption of syndemosis –> surgery

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what is a midfoot/ lisfranc fracture

fracture + dislocation at base of 2nd metatarsal

invx midfoot/ lisfranc fracture

CT = gold

what causes a colles fracture

FOOSH

what is a colles fracture + what deformity is present

Dorsally Displaced Distal radius --> Dinner fork Deformity

complications colles

median nerve injury --> weakness + loss of thumb or index finger flexion // compartment

3 features of a colles fracture

transverse radial fracture, 1 inch from radio-carpal joint, displaced dorsal fragments

what is a smith's fracture

reverse colles // volar angulation + distal fractments (garden spade

how does smith's fracture occur

fall backward onto outstrecthed hand / or fall onto flexed wrist

what is bennets fracture + xray

intra-articular base of thumb metacarpal // triangle fragment

what is barton's fracture

distal radial fracture (colles or smiths) + radio-carpal dislocation

what tends to cause scaphoid fractures

FOOSH or contact sport

blood supply to scaphoid

dorsal carpal branch (of radial artery) poor healing

complication scaphoid frature

AVN

signs scaphoid fracture (5)

tenderness over anatomical snuff box // joint effusion // pain on telescoping of thumb // tenderness on scaphoid tubercle // pain on ulnar deviation // loss of pinch

invx scaphoid injury

PA, lateral, and oblique X ray // CT // MRI = gold standard

inital mx scaphoid

furoturo or elbow backslap // review 7-10 days lateral if initial xray inconclusive

conservative mx scaphoid fracture

cast 6-8 weeks

which scaphoid fractures require surgical fixation

displaced scaphoid + proximal scaphoid pole fractures

what is a menteggia fracture

ulnar fracture with radioulnar dislocation at elbow

what is a galeazzi fracture

radial fracture with disloaction at distal (wrist) radioulnar joint

what age group to buckle fractures usually occur in

children 5-10

what are buckle fractures

incomplete fractures of the shaft of the long bone with a bulging cortex

mx buckle fracture

splint and immobilisation or cast

what is a nightsick fracture

ulnar shaft break from direct blow

what are greenstick fractures

bone bends and cracks - common in kids

most common fractured metatarsal

pinky - and most common midfoot

how do 5th metatarsal fractures happen

inversion injury of ankle

most common metatarsal for stress fracture

2nd

invx metatarsal fracture

xray or MRI

symptoms rib fracture

severe sharp chest wall pain // worse on breathing and cough // tenderness and bruising // low O2 sats or reduced breath sounds // pneumothorax

what is flail chest

multiple consecutive rib fractures --> flail segment moves and stops ventilation

invx rib fracture

1. CT // 2. CXR

mx rib fracture

usually conservative + analgesia (nerve blocks)

how do acromioclavicular injuries happen

FOOSH esp during sport

how are grade I-->5