Introduction to MS trauma Flashcards
Why is musculoskeletal trauma a major public health concern?
It is a leading cause of disability and death, especially in young adults, and can lead to long-term impairment if not managed properly.
What are the key components of a systematic trauma assessment?
Primary survey (ABCDE: Airway, Breathing, Circulation, Disability, Exposure), secondary survey (head-to-toe examination), and ongoing reassessment.
What is compartment syndrome and why is it dangerous?
A condition where increased pressure within a muscle compartment restricts blood flow, leading to tissue ischemia and necrosis if not treated promptly with fasciotomy.
How does a posterior hip dislocation commonly occur?
High-energy trauma, such as a dashboard injury in a car accident, forcing the femur posteriorly out of the acetabulum.
What are the clinical signs of a posterior hip dislocation?
Leg appears shortened, internally rotated, and adducted with severe pain and inability to move.
What is the Ottawa Ankle Rule and why is it used?
A clinical decision tool used to determine the need for X-ray imaging in ankle injuries, reducing unnecessary radiation exposure.
What is a Monteggia fracture-dislocation?
A fracture of the proximal ulna with dislocation of the radial head, commonly caused by a fall on an outstretched hand (FOOSH).
What is the difference between a Colles’ and Smith’s fracture?
Colles’ fracture: dorsal displacement of the distal radius (FOOSH injury); Smith’s fracture: volar displacement (fall on flexed wrist).
How do you differentiate between a sprain and a ligament tear?
A sprain involves mild stretching or partial tearing of ligaments, whereas a complete ligament tear results in significant instability and loss of function.
What are the risks associated with long bone fractures?
Hemorrhage, fat embolism syndrome, compartment syndrome, and infection (especially in open fractures).
What is the pathophysiology of fat embolism syndrome?
Fat droplets from marrow enter the bloodstream after long bone fractures, leading to pulmonary and cerebral microvascular occlusion.
What are the signs and symptoms of fat embolism syndrome?
Respiratory distress, petechial rash, altered mental status, and fever, typically occurring 24–72 hours post-injury.
Why is a pelvic fracture considered a life-threatening injury?
It can cause massive internal bleeding due to disruption of major pelvic vessels and requires urgent stabilization.
What is the difference between a tension pneumothorax and an open pneumothorax?
Tension pneumothorax: air trapped in the pleural space causing increased intrathoracic pressure; Open pneumothorax: air freely enters and exits the pleural cavity through an open chest wound.
How do you manage an open fracture in the emergency setting?
Control bleeding, cover the wound with a sterile dressing, immobilize the limb, administer antibiotics and tetanus prophylaxis, and prepare for surgical debridement.
What is the role of external fixation in trauma management?
It provides temporary stabilization of fractures, minimizes further soft tissue damage, and allows for wound care before definitive internal fixation.
Why is early mobilization important in musculoskeletal trauma patients?
Prevents complications such as deep vein thrombosis (DVT), pressure ulcers, muscle atrophy, and joint stiffness.
How does a scaphoid fracture present, and why is it often missed?
Presents with pain in the anatomical snuffbox; missed due to subtle X-ray findings and risk of avascular necrosis.
What is Volkmann’s ischemic contracture?
A severe complication of compartment syndrome in the forearm, leading to permanent flexion contractures due to ischemic necrosis of muscles.
What is the significance of neurovascular assessment in limb trauma?
Essential to detect compromised blood supply or nerve function, preventing complications like ischemia or permanent nerve damage.
What are the mechanisms and consequences of a crush injury?
Prolonged pressure on muscles leads to ischemia, rhabdomyolysis, and potential acute kidney injury due to myoglobin release.
What is the typical presentation of an Achilles tendon rupture?
Sudden pain in the back of the lower leg, inability to push off the foot, and a positive Thompson test (absence of plantar flexion with calf squeeze).
Why are femoral neck fractures common in elderly patients?
Osteoporosis and reduced bone density increase the risk of fractures from minor falls.
What are the principles of damage control orthopedics (DCO)?
Stabilization of life-threatening injuries first, followed by temporary fracture fixation, and definitive repair once the patient is stable.
What is the primary concern with open-book pelvic fractures?
High risk of severe hemorrhage due to disruption of pelvic ring integrity and damage to major blood vessels.
How do you diagnose and manage a knee dislocation?
Clinically evident gross deformity, requires immediate reduction and assessment for vascular injury (e.g., popliteal artery damage).
What is the most common cause of shoulder dislocation?
Anterior dislocation caused by forced abduction and external rotation of the arm.
What is a Galeazzi fracture?
A fracture of the distal radius with dislocation of the distal radioulnar joint, requiring surgical fixation.
Why is early rehabilitation crucial in musculoskeletal trauma recovery?
Enhances functional outcomes, prevents joint stiffness, and reduces long-term disability by promoting muscle strength and mobility.
What is rhabdomyolysis and its association with musculoskeletal trauma?
A condition caused by muscle breakdown releasing myoglobin, which can lead to acute kidney injury.
Why is deep vein thrombosis (DVT) a concern in trauma patients?
Immobility and endothelial injury increase clot formation risk, which can lead to life-threatening pulmonary embolism.
What are the long-term complications of a nonunion fracture?
Persistent pain, deformity, loss of function, and increased risk of secondary fractures.
