Goldenstien Trauma List 5 Flashcards
Stabilizers preventing posterolateral rotatory instability (3)
- Lateral ulnar collateral ligament
- Common extensor origin
- Joint capsule
Indications for surgical treatment of acute elbow dislocations (7)
- Open injuries
- Neurovascular injury
- Irreducible dislocation
- Incongruent reduction
- Incarcerated bony fragments/soft tissue
- Inability to maintain reduction in a safe position
- To treat associated fractures
Complications of elbow injuries in adults (4)
- Neurovascular injury
- Post-traumatic stiffness
- Heterotopic ossification
- Recurrent instability
Risk factors for heterotopic ossification in elbow injuries (5)
- Increasing severity of injury
- Delayed reduction of dislocation
- Forced passive motion
- Associated head injury
- Associated burns
Classification of Monteggia fractures (4)
- Type I: anterior (60%)
- Type II: posterior (15%)
- Type III: lateral
- Type IV: with proximal radius fracture
Causes of malreduction of the radial head in Monteggia fractures (3)’
- Non-anatomic reduction of the ulna
- Interposed annular ligament/capsule
- Intraarticular osteochondral fragment
Complications of Monteggia fractures (4)
- PIN palsy
- Redislocation/subluxation
- Proximal radioulnar synostosis
- Loss of ROM
Indications for surgical treatment of forearm shaft fractures (4)
- > 10° of angulation or > 50% shaft displacement
- Open fractures
- Both bones forearm fracture
- Polytrauma
Indications for acute bone grafting of forearm fractures (3)
- Comminution involving > 1/3 of the diaphyseal cortex
- Segmental bone loss
- Severe open fractures with poor local biology
Complications of forearm fractures (8)
- Compartment syndrome
- Nerve injury
- Infection
- Non-union
- Malunion
- Radioulnar synostosis
- Refracture after hardware removal
Risk factors for nonunion of forearm fractures
- Open fracture
- Comminution
- Segmental fractures
- Segmental bone loss
- Inadequate fixation
- Both bones fractures
Risk factors for refracture after hardware removal (3)
- Large plates
- Removal before 18 months
- No immobilization post-removal
Risk factors for radioulnar synostosis after surgical treatment of forearm fractures (13)
- Same level fracture of both bones
- Proximal 1/3 fractures
- Open fractures
- High energy injury
- Associated head injury
- Associated burns
- Delayed surgery
- Single incision surgery
- Insufficient stabilization
- Faulty plate location
- Screws projecting into the interosseous gap
- Primary corticocancellous bone grafting (especially if in contact with interosseous membrane)
- Cast immobilization post-osteosynthesis
(Injury, pre-op, operative, post-op)
Poor prognostic factors for outcome after synostosis resection (4)
- Proximal location
- Large synostosis
- Severity of the initial injury
- Later timing of resection
Radiographic signs of DRUJ instability in Galeazzi fractures (4)
Ulnar styloid fracture
Ulnar head dislocation on a true lateral XR
Widened DRUJ on PA XR
≥ 5 mm of radial shortening
Classification of distal radius fractures (Frykman) (8)
- Type I: extraarticular
- Type II: type I with an ulnar styloid fracture
- Type III: enters radiocarpal joint
- Type IV: type III with an ulnar styloid fracture
- Type V: enters radioulnar joint
- Type VI: type V with an ulnar styloid fracture
- Type VII: enters both radiocarpal and radioulnar joints
- Type VIII: type VII with an ulnar styloid fracture