Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Orthobullets/ FRCSC Canadian Board > Goldenstien Trauma List 6 > Flashcards

Goldenstien Trauma List 6 Flashcards

1
Q

Contraindications to ORIF of scaphoid nonunions (4)

A
  1. Smoker
  2. Older patient
  3. Progressive carpal arthrosis
  4. Chronic non-union
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Decision-making factors for treatment of scaphoid nonunions (3)

A
  1. Location of nonunion
  2. Vascularity
  3. Deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Radiologic findings of proximal pole AVN in scaphoid nonunions (4)

A
  1. Bone resorption
  2. Cystic changes
  3. Sclerosis
  4. Low signal on T1 and T2 MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complications of surgery for scaphoid nonunions (5)

A
  1. Persistent nonunion
  2. Hardware malpositioning
  3. Stiffness
  4. Chronic pain
  5. Nerve injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Classification of scaphoid nonunion advanced collapse (4)

A
  1. Stage I: the osteoarthritis is only localized in the distal scaphoid and radial styloid.
  2. Stage II: the osteoarthritis is localized in the entire radioscaphoid joint.
  3. Stage III: the osteoarthritis is localized in the entire radioscaphoid joint with involvement of the capitolunate joint.
  4. Stage IV: the osteoarthritis is located in the entire radiocarpal joint and in the intercarpal joints. It also may involve the distal radio-ulnar joint (DRUJ).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indications for ORIF of ulnar styloid fractures (4)

A
  1. Open injury
  2. Associated with DRUJ instability
  3. Significant displacement
  4. Large fragment involving the base
  5. Intraarticular fragment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Complications of DRUJ injuries (5)

A
  1. Late instability
  2. Post-traumatic arthritis
  3. Ulnocarpal abutment/impaction
  4. TFCC degeneration
  5. ECU tendon subluxation/dislocation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stages of perilunar instability (Mayfield) (4)

A
  1. Stage I: Scapholunate ligament tear (scapholunate dissociation)
  2. Stage II: capitolunate ligament tear
  3. Stage III: Lunotriquetral ligament tear (perilunate dislocation)
  4. Stage IV: dorsal radiolunate ligament tear (lunate dislocation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sequence of events in progressive perilunar instability (Mayfield) (7)

A
  1. Scaphoid extension
  2. Opening of the space of Poirier
  3. Scaphoid failure
  4. Distal row dissociation
  5. Triquetrum hyperextension
  6. Lunotriquetral ligament failure
  7. Dorsal dislocation of the carpus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Things to look for on XR of perilunate injuries

A
  1. Bones for fracture
  2. Carpal height
  3. Gilula’s lines
  4. Carpal interosseous spaces
  5. Scapholunate and radiolunate angles
  6. Rotatory positions in proximal row
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Intrinsic muscle releases for hand compartment syndrome (4)

A
  1. Thenar muscle release
  2. Hypothenar release
  3. Interossei release (2 dorsal incisions)
  4. Carpal tunnel release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Complications of nailbed injuries (8)

A
  1. Hypersensitivity
  2. Cold intolerance
  3. Split nail
  4. Hook nail
  5. Nonadherent nail
  6. Ingrown nail
  7. Ridging
  8. Osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Principles of treatment of fingertip injuries with tissue loss (5)

A
  1. Attempt to maintain length
  2. Prevent joint stiffness/contracture
  3. Preserve nail function if possible
  4. Provide sensate soft tissue to pulp
  5. Enable eventual pain-free use of the finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications for replantation in upper extremity traumatic amputations (5)

A
  1. Thumb (almost any level)
  2. Multiple digit amputations
  3. Metacarpal amputations through the palm
  4. Amputation at the wrist or proximal
  5. Almost anything in a child
  6. Individual digits distal to the FDS insertion (zone I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Contraindications to replantation (5)

A
  1. Single digit proximal to FDS insertion (zone II)
  2. Multitrauma
  3. Segmental injury/crush/avulsion
  4. Multiple medical comorbidities
  5. Poor rehabilitation potential
  6. Prolonged ischemic time (> 6 hours proximal to the carpus, > 12 warm/24 cold for a digit)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Principles of digit replantation surgical technique (8)

A
  1. Bone shortening and stable fixation
  2. Extensor tendon repair
  3. Flexor tendon repair
  4. Digital artery anastamosis (at least one/digit)
  5. Digital nerve repair
  6. Digital vein anastamosis (2 dorsal/digit)
  7. Skin repair
  8. Fasciotomies as needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of replantation failure (3)

A
  1. Arterial thrombosis
  2. Venous congestion/thrombosis
  3. Infection
18
Q

Options for surgical treatment of thumb amputations (4)

A
  1. Replantation (#1 choice)
  2. Revision amputation
  3. Toe-to-thumb transfer
  4. Pollicization
19
Q

Classification of ring avulsion injuries (Urbaniak) (3)

A

Type 1: circulation adequate

Type 2A: circulation inadequate, no bone/tendon injury

Type 2B: circulation inadequate, bone/tendon injury

Type 3: complete degloving

20
Q

Principles of digit amputation (6)

A
  1. Preserve functional length
  2. Maintain function and cosmesis
  3. Stable and nontender soft tissue coverage
  4. Preserve sensibility
  5. Avoid symptomatic neuromas
  6. Early mobilization
21
Q

Principles of treatment of high pressure injection injuries (5)

A
  1. Immediate decompression and mechanical debridement
  2. Wide exploration
  3. Leave wounds open
  4. Multiple debridements as needed
  5. Broad spectrum antibiotics
22
Q

Negative prognostic factors in high pressure injection injuries (5)

A
  1. Presentation > 10 hours after injection
  2. Pressure > 7000 psi
  3. Oil-based paint
  4. More material
  5. Injection into digit
23
Q

Classification of extensor tendon injuries (9)

A

Zone I: at the DIP joint

Zone II: over the middle phalanx

Zone III: at the PIP joint

Zone IV: over the proximal phalanx

Zone V: at the MCP joint

Zone VI: over the metacarpal

Zone VII: dorsal wrist

Zone VIII: distal forearm

Zone IX: proximal forearm

24
Q

Classification of mallet finger (zone I extensor tendon injuries) (4)

A

Type I: closed/blunt trauma ± a small chip fracture

Type II: laceration at or proximal to DIP

Type III: deep abrasion with loss of tendon substance

Type IV: physeal fracture in children

25
Q

Indications for surgical fixation of a mallet finger (4)

A
  1. Fracture fragment ≥ 30% of the articular surface
  2. Displacement > 2 mm
  3. Volar subluxation of the distal phalanx
  4. Occupation prevents splinting
26
Q

Complications of mallet fingers (9)

A
  1. Persistent deformity/extensor lag
  2. Secondary swan neck deformity
  3. Post-traumatic DIP arthritis
  4. Skin slough
  5. Nail deformity
  6. Joint incongruity
  7. Infection
  8. Pin failure
  9. Subluxation
27
Q

Causes of boutonniere deformity with zone III extensor tendon injuries (3)

A
  1. Central slip rupture
  2. Triangular ligament injury/attenuation
  3. Lateral band volar migration
28
Q

Indications for surgical treatment of zone III extensor tendon injuries (central slip rupture) (3)

A
  1. Avulsion with a bone fragment
  2. Acute injury with volar subluxation of the lateral bands (traumatic boutonniere)
  3. Delayed treatment of a missed central slip injury
29
Q

Poor prognostic factors for delayed treatment of a central slip rupture (3)

A
  1. PIP contracture > 30°
  2. Failure to regain full extension preoperatively
  3. Age > 45 years
30
Q

Classification of flexor tendon laceration (Verdan) (5)

A

Zone I: distal to FDS insertion

Zone II: within the fibroosseous tunnel (“no man’s land”)

Zone III: in the palm

Zone IV: within the carpal tunnel

Zone V: proximal to the carpal tunnel

31
Q

Criteria for successful flexor tendon repair (6)

A
  1. Appropriate timing (up to 10 days)
  2. Appropriate incisions
  3. Minimal touching of tendon
  4. Preserve pulleys
  5. Core and epitendinous suture repair
  6. Early protected ROM
32
Q

Principles of tendon repair (3)

A
  1. Strength proportional to the # of strands crossing repair
  2. Dorsal placement stronger
  3. Best suture configuration is a 4-strand Kessler with epitendinous repair
33
Q

Advantages of adding an epitendinous repair (3)

A
  1. Increases strength of repair
  2. Decreases gap formation at repair site
  3. Improves tendon gliding by smoothing repair
34
Q

Methods to increase the strength of a flexor tendon repair (3)

A
  1. Adding an epitenon repair
  2. More sutures across repair site
  3. Dorsal sutures
35
Q

Classification of flexor digitorum profundus avulsion injuries (“Jersey finger” - Leddy & Packer) (3)

A
  1. Type I: retracted into palm, vincula disrupted
  2. Type II: retracted to A2/3 pulley, vincula intact
  3. Type III: bony avulsion with retraction to the A4 pulley (DIP)
  4. Type IIIA: fracture and tendon avulsion
36
Q

Principles of rehabilitation of flexor tendon injuries (3)

A
  1. Dorsal block splint for 6 weeks (30°wrist flexion, 70° MCP flexion)
  2. 4 weeks of passive PIP/DIP flexion
  3. Active flexion started at 4 weeks
37
Q

Negative prognostic factors following flexor tendon repair (5)

A
  1. Crush injury
  2. Associated fracture
  3. Skin loss
  4. Zone II injuries
  5. Increasing age
38
Q

Complications of repair of flexor tendons (3)

A
  1. Flexion contracture
  2. Lumbrical plus finger (IP extension with finger flexion)
  3. Quadrigia effect
39
Q

Indications for flexor tendon reconstruction (5)

A
  1. Failed repair
  2. Stiff digit
  3. Chronic laceration
  4. Scarred bed
  5. Incompetent pulley system
40
Q

Requirements for flexor tendon reconstruction (4)

A
  1. Supple, mature skin
  2. Adequate vascularity
  3. Sensate finger
  4. Full passive ROM

Orthobullets/ FRCSC Canadian Board (121 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions