L2 Fractures Flashcards

Question

Salter-Harris Classification of growth plate injuries

Answer 1

5 different types used with immature bone applies to any bone with a growth plate

Answer 2

through the growth plate, transverse

Answer 3

transverse fx through growth plate and metaphysis, travels proximally

Answer 4

through growth plate and epiphysis, travels distally and exits into the adjacent joint

Answer 5

through all three elements, travels proximally and distally most damaging problem can cause incongruency and fracture into the joint space

Answer 6

crush injury of growth plate

Answer 7

common extra-articular fx of distal radius at distal radial metaphyseal region with dorsal angulation and impaction, without involvement of articular surface

Answer 8

closed reduction and cast immobilization cast should go from the elbow to the metacarpal heads. Wrist is in slight flexion and ulnar deviation patients should perform active finger motion exercises

Answer 9

a removable splint can be worn

Answer 10

should have repeated xrays for three weeks and the use of a splint or cast is discontinued

Answer 11

convex concave

Answer 12

dinner fork deformity

Answer 13

relatively common in older patients, those with unsteady gait, reduced bone density, females this fx has significant complications w/out surgery, including avascular necrosis and non union can weight bear as tolerated

Answer 14

MOI: axial loading like falling from a signficant height fractures on the lateral plateau are more common than medial soft tissue injuries are in 10% of fxs

Answer 15

younger = splitting pattern older = depression pattern, most common with osteoporosis

Answer 16

1. early mobilization -- >3 weeks of immob increasing the potential for losing ROM permanently 2. left uncorrected, the depression of plateau can cause a varus/valgus deformity, with increased OA 3. PT can detect ligament injuries, which can lead to OA and malalignment

Answer 17

also known as a wedge deformity caused by an isolated failure of anterior column, usually due to forward flexion and compression

Answer 18

normally a stable fracture early ambulation is encouraged should use a hyperextension orthoses avoidance of compression overloads for a period of 12 weeks

Answer 19

compression burst flexion-distraction

Answer 20

most common type of MC fx, usually in young adult males transverse fx of the 5th metacarpal. Occurs in the transverse plane through metacarpal neck, Dorsal angulation of distal fragment

Answer 21

relatively unstable, so wire fixation is often required palmar angulation is fine, but rotational deformity is NOT. can cause significant deformity with the little finger covering the other digits can also use a short arm splint, with flexion of MCP joint, for 2-3 weeks

Answer 22

small bone fragments at the end of long bones, adjacent to joints usually occur in locations with tendon or ligament attachments MOI: tension force

Answer 23

typically stable surgery is required for pain or to regain anatomic fixation treated on an outpatient basis with crutches pain meds, modified pain recovery is in 4 to 6 weeks

Answer 24

-3-5% of all fractures -common in younger males and older females -usually the middle third of the humerus is fx most commonly associated with a radial nerve injury

Answer 25

direct blow to the upper arm = transverse indirect trauma from fall or twisting = spiral/oblique/open

Answer 26

-supportive cast and then splint -does not require ORIF -shortening with some angulation is fine

Answer 27

1. adequate alignment cannot be maintained 2. open fx 3. presence of vascular injury 4. segmental fracture 5. poly-trauma, brachial plexus injury 6. non-union 7. pathological etiology

Answer 28

associated with middle 1/3 humeral shaft fx -can either be a laceration, entrapment, crush, demylenation (neuropraxia) a closed fx will see the nerve heal within 3-4 months

Answer 29

open fx, irreducible fx, vascular injuries, radial nerve palsy after manupulation, intractable neuro pain 16-18 weeks of management after surgery

Answer 30

transverse fracture at the base of the fifth metatarsal MOI: significant adduction force to the forefoot with ankle in PF common athletic injury, often mistreated

Answer 31

prone to non-union; need to use internal fixation or grafting immobilization is important; NWB cast for 6-8 wks

Answer 32

abnormal separation of two anatomical structures that are normally located together MOI: shear and tension (falling from a horse)

Answer 33

occurring due to a mismatch of bone strength and chronic mechanical stress can either be fatigue or insufficiency

Answer 34

abnormal stresses on normal bone

Answer 35

normal stresses on abnormal bone an example of a pathological fracture

Answer 36

tibia tarsals metatarsals femur pelvic ring

Answer 37

athletes military dancers female

Answer 38

repetitive overuse sudden change in training regimen alterations in training surface female leg length discrepancy diminished muscle strength

Answer 39

pattern of decreased WB tolerance over time localized pain tenderness with palpation antalgic gait minimal joint ROM loss for extra-articular lesions

Answer 40

NO low sensitivities plain films can be negative for 14 to 21 days MRI and bone scan are the gold standard

Answer 41

percuss distal to suspected lesion, while auscultate proximal to suspected lesion confounding factors are joint effusion, bilateral injury, non-traumatic lesions positive test lets us know that there is a bone pathology

Answer 42

dependent on location options include conservative, plaster cast, internal fixation you must reduce the activity which has led to the fracture

Answer 43

incomplete fracture intact periosteum lack of significant angulation avulsion and compression are usually stable

Answer 44

shear injuries tend to be unstable periosteal tissue disruption leads to increased fx instability unstable fx will display gross motion between shaft and head fragments

Answer 45

A = tension side of neck B = compression side of neck, less likely to be displaced, more stable

Answer 46

isolated fracture of the ulnar shaft

Answer 47

displaced < 50% periosteum and interosseus membrane intact and act as restraint to rotation

Answer 48

displaced >50% or at a 10-15° of angulation displacement/angulation towards the IM is poorly tolerated associated with radial head fx or dislocation

Answer 49

permits some transmission of load across fracture site ex: cast, rods, pins, wires

Answer 50

protects the fracture completely from mechanical stress, transfers stress to the fixation device ex: surgical plates, external fixators

Answer 51

1. Hemorrhage 2. Fat embolism 3. Brachial artery injury 4. Axillary nerve injuries 5. Avascular necrosis

Answer 52

pelvic fractures closed femoral fx

Answer 53

multiple or crushing type injuries, develops within 3 days of injury

Answer 54

supracondylar fx

Answer 55

proximal humeral fx

Answer 56

scaphoid fx

Answer 57

sneeze, misstep, lifting a gallon milk, raising a window, basic ADLs, etc

Answer 58

vertebral bodies femur distal radius

Answer 59

family hx caucasian/asian female age 50+ low body weight immobilization inactivity long term exposure to alcohol, tobacco medications co-morbidities dietary deficiencies northern european ancestry

Answer 60

aluminum anticonvulsants corticosteroids cytotoxic drugs excessive thryoxine heparin lithium tamoxifen

Answer 61

diabetes enodmetriosis MS COPD hyperthyroidism

Answer 62

metastatic tumors most common >50 shoes up as localized pain, palpable tenderness, edema, mass, fever, weight loss, malaise

Answer 63

osteosarcoma

Answer 64

osteochondroma

Answer 65

most common in bone tumor in children occurs in the knee usually, proximal humerus, proximal femur, pelvis S/S: painless bony mass, limited ROM

Answer 66

an abnormal extension of metaplastic cartilage that responds to the factors that stimulates the growth plate resulting in exotosis growth most common at knee, in males, younger than 20