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ESA 2- MSK > Injuries Of Joints (5) > Flashcards

Injuries Of Joints (5) Flashcards

0
Q

What are the most common injuries to synovial joints?

A
  • Dislocation
  • Fracture (intra-articular)
  • Fracture-dislocation
  • Sprain (ligament injury)
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1
Q

What are the three main functions of joints?

A
  • Motion
  • Shock absorber
  • Growth
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2
Q

When presented with an injury what are the main points that need to be addressed about how the injury as caused?

A
  • Low/high velocity injury
  • Fatalities
  • Self extricated (managed to get out themselves)
  • Speed
  • Airbag/seatbelt/helmet
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3
Q

What are the main things to examine for?

A
  • LOOK: swelling/bruising/wounds/deformity
  • FEEL: Joint fluid/painful sites/crepitus(crunching)
  • MOVE: Range of movement (passive/active)
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4
Q

Outline the Gustillo & Anderson assessment.

A
  • I: 1cm moderate contamination
  • III: High velocity severe contamination
    Then:
  • A: Adequate skin coverage
  • B: Bone exposed
  • C: Circulation compromised
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5
Q

What is the most important thing to document before any treatment occurs?

A
  • Neurovascular status
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6
Q

What neurovascular structure is at risk with the following injuries:

  • Distal radius (Colles)
  • Dorsal ⅓ humerus
  • Shoulder dislocation
  • Hip dislocation
  • Knee dislocation
A
  • Distal radius: MEDIAN
  • Distal ⅓ humerus: RADIAL
  • Shoulder dislocation: AXILLARY
  • Hip dislocation: SCIATIC
  • Knee dislocation: POPLITEAL A/COMMON PERONEAL
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7
Q

What are the different types of investigations that can be used for injuries?

A
  • X ray (anterior-posterior and lateral)
  • Stress views
  • MRI
  • CT
  • Aspiration
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8
Q

What is the rule for X-rays?

A
  • 2 bones
  • 2 joints
  • 2 sides
  • 2 views
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9
Q

What is the definition of a fracture?

A
  • Soft tissue injury with underlying break in bony cortex.
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10
Q

What are the possible causes of a fracture?

A
  • Trauma
  • Pathological (fracture occurring through abnormal bone under physiological load)
  • Stress
  • Insufficiency (osteoporosis)
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11
Q

When describing a fracture what needs to be covered?

A
  • Mechanism: fracture pattern, energy, soft tissue envelope, skeletal maturity
  • Pathological: local/systemic
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12
Q

For fracture healing there are 3 stages what are these and how long do they take?

A
  • Inflammation: 1-5 days
  • Reparative: 4-40 days
  • Remodelling: 25-200 days
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13
Q

What is the key thing for bone repair?

A
  • Stability

- So can heal via callus

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14
Q

What are the systemic factors affecting healing?

A
  • Age
  • Malnutrition
  • General health
  • Generalised atherosclerosis
  • Smoking
  • Drugs
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15
Q

What are the local factors affecting healing?

A
  • Degree of local trauma/bone loss
  • Area of bone affected
  • Abnormal bone = slower to heal
  • Degree of immobilisation of fracture - motion delays healing
  • ## Disruption of vascular supply
16
Q

How do you describe a fracture? OLD ACID

A
  • Open vs Closed
  • Location
  • Degree
  • Articular extension
  • Comminution (no. of pieces)
  • Intrinsic bone quality
  • Displaced/angulation/rotation
17
Q

What is valgus and varus?

A
  • Valgus: apex medial

- Varus: apex lateral

18
Q

What are the 3 main goals for fracture treatment?

A
  • Reduce
  • Hold (plaster/sling)
  • Rehabilitation
19
Q

What are the local early fracture complications?

A
  • Nerve injury
  • Vascular injury
  • Compartment syndrome (high pressure)
  • Avascular necrosis
  • Infection
  • Surgical
20
Q

What are the systemic early fracture complications?

A
  • Shock / hypovolaemia
  • Fat embolism
  • Thromboembolism
  • Acute respiratory distress syndrome
  • Disseminated intravascular coagulation
21
Q

What are the local late fracture complications?

A
  • Delayed/mal/non - union
  • Myositis ossificans
  • Refracture
22
Q

What are the regional late fracture complications?

A
  • Osteoporosis
  • Joint stiffness
  • Chronic regional pain syndrome
  • Abnormal biomechanic osteoathrosis
23
Q

What is a sprain and the common sites for one?

A
  • Damage to ligament
  • Ankle
  • Knee
  • Thumb (joints of the hand)
24
Q

What are the Ottawa ankle rules?

A
  • X-ray only if there’s pain in:
  • Posterior edge or tip of medial/lateral malleolus
  • Base of 5th metatarsal
  • Navicular
  • Or inability to weight bear in ED
25
Q

What is the management of a sprain?

A
  • Rest
  • Ice
  • Compression
  • Elevate
26
Q

What are the possible causes of joint injury?

A
  • Pain
  • Stiffness
  • Deformity
  • Loss of function
  • Loss of limb (extreme)

ESA 2- MSK (10 decks)

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