Fractures - Upper body Flashcards

1
Q

Depressed skull # can be managed by elevation. Extra care should be taken when # occurs in what location of the skull, why?

A

Midline depressed skull #
Elevation attempt may tear the sagittal sinus causing profuse and fatal bleeding

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2
Q

Simple, basic principle to detect fractures?

A

Axial compression, holding the proximal and distal ends of the suspected bone

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3
Q

Raccoon eyes are seen is which kind of #?

A

Base of the skull#
Bleeding from ear, nose, throat
Oto/Rhinorrhoea when dura matter is torn

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4
Q

Will all the base of skull# lead to otorrhoea/rhinorrhoea?

A

No
Dura matter tear leads to oto/rhinorrhoea

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5
Q

Circum-ocular hematoma, depression of infra orbital margin is seen in what fracture? What are other clinical features?

A

Malar/Zygomaticomaxillary complex#

Other C/F:
1. Swollen cheek
2. Subconjunctival haemorrhage
*3. Infra-orbital nerve damage - cheek
parasthesia
4. Infra-orbital margin- palpable step
5. Loss of malar prominence
6. Jaw opening - difficult

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6
Q

Which malar fracture requires reduction under general anaesthesia?

A

Displaced malar fracture

Method: Elevation by intra-oral or temporal approach

May require interosseous wiring, pinning or plating

Healing in 3-4 wks

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7
Q

Mandible fracture management

A

First aid: 4 tailed bandage
Rx: Internal fixation
Heals by 6-12wks

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8
Q

Dislocated jaw management

A

Downward traction with thumbs, additional reinforcement by rotating upwards with fingers

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9
Q

Which spinal fracture is associated with Kidney rupture?

A

L1

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10
Q

Stable spinal fractures

A

<50% compression of vertebral height

Laminar/minor fractures

Complete immobilisation (only in spinal#, tolerated mobility advised in other spinal problems)

Spinal brace, physio

Heals in 6-12 wks

DEXA/Bone density test in old for osteoporosis

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11
Q

Do unstable spinal fractures lead to partial or complete paraplegia?

A

Both

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12
Q

Rib fracture

A

Very painful
Rx: Analgesics, intercostal nerve block, elastic rib belt

Pneumothorax, spleen, hepatic, kidney injury (check)

Heals in 3-6wks

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13
Q

Clavicle fracture

A
  1. Fall on outstretched hand/direct blow
  2. Medial 1/3# mc
  3. C/F: Pain with shoulder movement, supports arm at elbow, clasped to chest
  4. Rx:
    St Johns elevated brace/figure of 8 brace - even with over-riding of #, <2cm compression
    Open reduction in >2cm shortening, denting of skin
  5. Heals in 4-8wks

Check orthobullets for pics

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