LE Ortho Flashcards
hip dislocation presentation (2)
posterior: adduction & internally rotated
anterior: slight abduction & external rotation
hip fx presentation (2)
pain to groin, radiating to inner thigh
leg held in external rotation/abduction
neck/head of femur within capsule
concerns for loss of blood supply, avascular necrosis
intracapsular hip fx
fx b/w neck & lesser trochanter of femur
intertrochanteric
subtrochanteric fx
below lesser trochanter of femur
Kocher criteria (4)
WBC 12,000+
ESR 40+
fever 101.3+
NWB on affected side
SCFE ROM restriction
abduction & internal rotation
SCFE with radiographic evidence of slip and less than 3 weeks symptoms
acute
acute-on-chronic SCFE
pain more than 3 weeks
effusion and metaphyseal remodeling seen on imaging
imaging finding for chronic SCFE
metaphyseal remodeling but no effusion
tibial plateau MOI (3) & associated injuries (2)
falls, contact sports, motorcycle injury
a/w meniscus, ligament injury
tibial plateau fx treatment
splint in full extension, NWB up to 6 weeks
proximal tibia fx common MOI & tx
trampolines
long leg cast
tibial shaft fx MOI
and caution
twisting of the leg with the foot planted, direct impact, fall
avoid tight Ace bandages or early casting due to swelling- high risk for anterior compartment syndrome
tibial shaft fx tx (2)
NWB
long leg splint
pediatric tibial shaft fx MOI, presentation, and treatment
child falling while running, often with twisting mechanism
pt won’t walk on foot, may look like foot pain
casting- splint anyways, refer even if you don’t see it on X-rays
a/w with lateral malleolus fx?
lateral ligament complex sprain
ankle fx tx
splinting, brace, CAM boot
RICE, NWB
metatarsal stress fx is most common in?
3rd MT due to repetitive activity
5th MT avulsion due to? (2)
and treatment? (3)
inversion, high heels
cast/CAM boot
restricted WB
activity modification
Jones fx
and treatment?
base of the 5th MT at the metaphyseal/diaphyseal junction
requires surgery due to slow healing
Lisfranc fx
& MOI
presentation
fracture or dislocation of 1st and 2nd TMT
stepping off curb or into hole, MVA, fall
mid foot pain
Lisfranc fx imaging & treatment (2)
AP bilateral WB feet, lateral X-rays
needs stabilization early! casting
surgery if > 2 mm
Calcaneal fx imaging & tx
lateral view most helpful
casting w/ NWB
surgery only if displacement
positive Thompson test?
intact achilles tendon
squeeze calf –> plantarflexion
Achilles tendon tear tx
splint/boot in plantar flexion, usually can treat conservatively
most common pattern of pelvic fx
posterior wall fx w/ possible assoc. femoral head dislocation
