fractures: specific injuries Flashcards
what bones form the pelvis
sacrum, ilium, ischium, pubic phones
what causes open book pelvis fractures
anteroposterior compression –> pubic symphysis splits
blood supply to pelvis
internal iliacs and sacral venous plexus
symptoms hip fracure
shortened and externally rotated leg
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
mx undisplaced intracapsular hip fracture
internal fixation (or THR if unfit)
mx displaced intracapsular hip fracture
THR or hemiplasty
mx extracapsular hip fractures
stable trochanteric fracture = hip screw // oblique, transverse or subtronchateric = intremedullary device
most common direction for hip dislocation
posterior
posterior hip dislocation symtpoms
shortened leg, adducted, internally rotated
anterior hip dislocation symptoms
not shortened, abducted and externally rotated
mx hip dislocation
MUA within 4 hrs to prevent AVN
complications hip dislocation
sciatic or femoral nerve injury, AVN, OA, dislocation
mx femoral shaft break
closed reduction + intramedullary nails
mechanism of patella fractures
direct eg dashboard injury // indirect eg quads contracts too hardly
symptoms patella fracture
significant bruising and swelling, palpable gap, straight leg test
invx patella fracture
2 planes of xray –> skyline
mx patella fracture
undisplaced + intact extensor mechanism = 6 weeks brace + fully weight bear // displaced = consider operative
mx proximal tibia fracture
intra-articular –> ORIF + plates and screws
ottawa rules ankle injury
xray if pain over malleos + one of: bony tenderness on lateral or medial malleoulus, cannot weight bear
weber classification for ankle breaks
A = below syndemosis // B = level of tibieal plafond // C = above syndemosis
what is a maisonnoivre fracture
spiral tibial fracture –> wide ankle joint + disruption of syndemosis –> surgery
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
- 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
