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Disciplines 3 Shea > Fx 2 Shea > Flashcards

Fx 2 Shea Flashcards

1
Q

2 MOI of Radial Head Fx and which is MC?

A
  • FOOSH w/ partially flexed elbow (MC) (radial head is jammed into humerus)
  • Posterior elbow dislocation
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2
Q

Which fx?

  • Swelling over lateral elbow
  • Limited ROM (esp extension and supination)
A

Radial Head Fx

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3
Q

What Classification is used for Radial Head Fx?

A

Mason

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4
Q

Radial Head Fx - Mason Classification

Type 1

Type 2

Type 3

A
  • 1: Single fx, no displacement
  • 2: displacement
  • 3: comminuted (multiple fxs)
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5
Q

What 3 x-ray views should be obtained for Radial Head Fx?

A
  • AP
  • Lateral
  • Oblique (type 1 may be occult/hidden on initial x-ray), so look for fat pads
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6
Q

Radial Head Fx

Nonsurg tx Type 1

  • Splint or Sling for __ to ___ days w/use of sling for comfort there after
  • Early ROM is important (esp ____ and ____)
A
  • 5 to 7 days
  • Supination and Extension of elbow
  • Most painful is (supination/extension)
  • Most comf is 90 degree and pronation
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7
Q

Radial Head Fx

Non-surg Type 2

  • Minimal displacement,
    • splint for __ to ___ days w/ use of sling for comfort
    • ______ ROM following D/C splint
  • Moderate displacement,
    • ORIF (open reduction internal fixation)
A
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8
Q

Radial Head Fx

Surgical for Type 3

A

Radial Head Replacement

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9
Q

W/ Forearm Fxs, what creates the “stable ring?”

A
  • Proximal radioulnar joint
  • Distal radioulnar joint
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10
Q

What classifies a forearm fx as “unstable” and how are they all managed?

A
  • Disruption in more than 1 component of ring –> unstable rx, (high likelyhood will shift)
  • Surgically.
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11
Q

Forearm Fx

  • Fx of both bones w/o disruption of radioulnar joints
A

Unstable Fx

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12
Q

Forearm Fx

  • Fx of single bone, w/ disruption of ONE radioulnar joint
A

Unstable fx

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13
Q

2 MOI of Forearm Fx

A
  • High Impact (MC)
    • MVA
    • Fall from ladder/height
  • Direct blow
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14
Q
  • What is a stable forearm fx called which involves mid to distal ulnar shaft fx?
  • How is it tx?
A

“Nightstick Fx”

  • policeman holding night stick/baton
  • Individual who did something bad, police hit person w/ baton, so pt holds up forearm and baton strikes the ulna which gets fractured.

(tx non-surg bc/ stable)

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15
Q

Unstable Forearm Fractures

  • Radial shaft fx
  • Ulnar shaft fx
A

Both Bone forearm fx

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16
Q

Unstable Forearm Fractures

  • Mid to proximal ulnar shaft fx
  • Associated radial head dislocation
A

Monteggia fx

(MUR)

Monteggia / Ulnar / Radial Head

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17
Q

Unstable Forearm Fractures

  • Mid to distal radial shaft fx
  • Associated carpoulnar dislocation
A

Galeazzi Fx

(GRC)

Gal / Radial / Carpo

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18
Q

How are unstable forearm fx managed?

A

Surgical

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19
Q

Which fx?

  • MOI: FOOSH w/ wrist in extension (MC) –> Colle’s Fx
    • Postmenopausal women 60-70%
  • FOOSH w/ wrist in flexion –> Smith’s fx
  • Direct Trauma
A

Distal Radial Fx

20
Q

“Every Cat wants Dinner and Finds Someone in the Garden”

A

Distal radial Fx

Extension = Colle’s = dinner fork

Flexion = Smith’s = garden

21
Q

Which fx?

  • Dinner fork deformity (colle’s)
  • Garden spade deformity (smith’s)
  • Localized swelling
  • Potential ___ nerve injury
  • Significant ROM limitation
A

Distal Radial Fx

22
Q

What x-ray views for Distal Radial Fxs

A
  • AP
  • Lateral
  • Oblique
23
Q

Distal Radial Fx

Non-surg

  • Non-displaced –>
  • Displaced –>
A
  • Non: Short arm cast
  • Dis: Long arm cast
24
Q

Indication for surgery in Distal Radial Fx

A
  • Intra-articular extension
  • Severe comminution
  • Inability to maintain reduction
25
Q

Which fx?

  • Radial torus “buckle” fx
  • MC in children <___ yrs
  • Distal metaphysis
  • Buckling of cortex due to compression fx
A

Pediatric Distal Radial Fx

26
Q
  • MOI of Buckle/torus/distal radial fx
  • Deformity?
  • Amt swelling?
A
  • FOOSH
  • None visible
  • Mild to mod
27
Q

Cast tx for TOrus / buckle fx / distal radial fx?

A

Short arm for 4-6 wks

28
Q

Is greenstick or torus more common?

A

Torus

29
Q

Which fx?

  • Complete fx of tension side w/ buckling of compression side
  • MOI: FOOSH
A

Greenstick Fx

30
Q

Greenstick fx

  • Swelling?
  • Deformity?
A
  • Mod to sig swelling
  • +/- visible deformity
31
Q

Cast tx for Radial Greenstick Fx?

A
  • short arm for 6-8 wks
  • (rarely surgery)
32
Q

Which fx?

  • Most common carpal bone fx
  • FOOSH
  • Snuffbox pain / TTP
  • ROM limitations
  • Commonly occult on x-ray
A

Scaphoid fx

33
Q

Scaphoid fx can cause limited blood supply which leads to high incidence of what 2 things?

A
  • Nonunion
  • Osteonecrosis
34
Q

4 x-ray views of Scaphoid fx

A
  • PA
  • PA w/ ulnar deviation
  • Lateral
  • Semi-pronated oblique
35
Q

Tx for scaphoid fx? (3)

A
  • Long-arm thumb spica cast for 6-12 wks
  • If clinical exam is indicative of fx, but x-rays are negative –> splint and repeat x-rays in 10-14 days
  • If FU x-ray negative, but clinical concern persists, get MRI.
36
Q

Fx of Metacarpals/Phalanges

  • Displaced ___ and ____ fxs tend to angulate
  • ____ fxs tend to rotate
A
  • Transverse and Oblique
  • Spiral
37
Q
A

a : Transverse shaft fracture
b : Oblique shaft fracture
c : Spiral shaft fracture
d : Metacarpal base fracture
e : Metacarpal head fracture
f : Comminuted fracture

38
Q

What is shown? Which type of fx?

A

Malrotation

Scaphoid

39
Q
  • What is the MC fx of the hand
  • MOI?
  • possibly malrotation deformity
  • possibly dropped knuckle deformity
A
  • 5th metacarpal fx (boxer’s fx)
  • Distal metaphysis of 5th metacarpal
  • Closed fist striking an object
40
Q

Tx for 5th metacarpal fx (boxers)

Nonsurg:

  • <15 degree angulation
  • transverse/oblique/base/head fxs
A
  • Ulnar gutter splint
41
Q

Which fx?

  • Traumatic injury to tip of fully extended finger –> avulsion of extensor tendon at base of distal phalynx
  • Tender rupture/Tendon laceration
  • Visible deformity
  • Inability to ____ the affected ___ joint
A

Extensor Tendon Avulsion Fx (mallet finger)

  • extend
  • DIP
42
Q

non-surg Tx for mallet/ extensor tendon avulsion fx

A
  • Continuous splint 6-8 wks
  • (if extension is lost at all, healing is disrupted and the 6-8 week clock starts over again)
43
Q

3 indications for surg tx or extensor tendon avulson/mallet

A
  • conservative care fails
  • Complete tendon lac
  • Fx involving >30% of articular surface
44
Q

Which fx?

  • Traumatic forced extension of actively flexed finger –> avulsion of flexor tendon at base of distal phalynx
  • Which finger?
  • Deformity?
A

Flexor Tendon Avulsion Fx (Jersey finger)

4th (ring) is MC

inability to flex affected DIP

45
Q

Tx for Flexor TEndon avulsion fx / jersey finger?

A

Early surgical repair in ALL cases

Splint in presenting position and then hand surgeon referral

Best recovery if repaired within 7-10 days of injury

46
Q

Which fx?

  • MOI: direct blow from door/hammer
  • Subungual hematomas (be cautious)
A

Distal Phalanx Fx

47
Q

Tx for Distal Phalanx Fx

A
  • Mostly non-surg
  • Surg: angulated >15 degrees / >2mm displacement / non-union

Disciplines 3 Shea (13 decks)

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