LE Orthopedics (Exam #4) Flashcards
What is the most common type of Pelvic Fracture, and what associated injury is often seen?
Posterior fracture
+/- femoral head dislocation
With Pelvic Fractures, what non-bone injuries may be seen?
Internal abdominal injuries
What is a major complication of Pelvic Fractures, and therefore, what two exams should be performed?
BLEEDING
- Pelvic exam
- Rectal exam
What is the gold standard dx test for Pelvic Fractures?
CT
What condition involves XR views of Judet views, inlet/outlet views?
Pelvic Fracture
What direction of Hip Dislocation is more common?
POSTERIOR
What condition involves PAIN, inability to WB; leg appears shorter?
Hip Dislocation
What nerve should be checked with a Hip Dislocation?
Sciatic n.
How does presentation of a POSTERIOR Hip Dislocation differ from an ANTERIOR Hip Dislocation (2)?
- Posterior = fixed adduction, internal rotation
- Anterior = slight abduction, external rotation
What is the recommended tx for a Hip Dislocation, and in what time frame?
EMERGENT reduction within 6 hours
What type of fracture is associated with an increased risk of morbidity/mortality in elderly?
Proximal Femoral Fracture
What type of fracture are Femoral Neck Fractures?
Intracapsular
How does a Proximal Femoral Fracture present?
- Abduction
- External rotation
Opposite of posterior hip dislocation
What is a major consideration in the tx of a Proximal Femoral Fracture?
DVT prophylaxis
What condition requires severe trauma/force (vs. pathologic or fall in elderly); common in young males?
Femoral Shaft Fracture
What type of fracture should you consider abuse if in a non-ambulatory child?
Femoral Shaft Fracture
What is a major complication associated with Femoral Shaft Fractures?
Malunion/delayed union/nonunion
What type of dislocation is an Ortho EMERGENCY?
Knee Dislocation
What two non-bone injuries should be considered with a Knee Dislocation?
- Neuro injury
- Vascular injury
What three dx tests should be ordered for a Knee Dislocation?
- XR
- CT
- MRI
Need to evaluate nerves and vascular, not just bone
What is the recommended tx for a Knee Dislocation (2)?
- EMERGENT reduction
- Surgery
What direction of Patellar Dislocation is more common?
Lateral
- There is less soft tissue to stabilize that side
What condition involves knee “gives way”, severe pain?
Patellar Dislocation
What is the recommended tx for a Patellar Dislocation? What tx should be considered for more long-term?
- Immediate reduction
- Knee immobilizer in FULL EXTENSION
For what three injuries is immobilizer/cast/splint in FULL EXTENSION recommended as tx?
- Patellar Dislocation
- Patellar Fracture
- Tibial Plateau Fracture
What two conditions involves knee fixed in knee flexion, deformity, swelling, hemarthrosis?
- Patellar Dislocation
- Patellar Fracture
What type of fracture should be considered with a Tibial Plateau Fracture?
OPEN
What is often the recommended tx for a Patellar Fracture?
Cast/splint in FULL EXTENSION
What is often the recommended tx for a Tibial Plateau Fracture?
Cast/splint in FULL EXTENSION
What are the two most common MOI for Ankle Fractures?
- Inversion injury
- Eversion injury
What condition involves the Ottawa Ankle Rules, and what does it involve (__ AND 1+ of (3))?
Ankle Fractures
Malleolar tenderness AND 1+ of…
- Posterior fibula pain
- Posterior distal tibia pain
- Inability to WB
What are the three types of Malleolar Fractures, and what are two different combinations that you may see?
Medial, Lateral, Posterior
- Bimalleolar = Medial + Lateral
- Trimalleolar = all three
What type of Ankle Fracture is often seen in PEDS; involves joint so emergent?
Tilleaux/Triplane Fractures
What is the most common type of Metatarsal Fractures in adults?
5th Metatarsal
What type of Metatarsal Fracture is at risk of non-union?
Jones fracture
What is often the recommended tx for Metatarsal Fractures?
Conservative (CAM boot or cast)
What condition involves fracture AND dislocation of 1st and 2nd TMT?
Lisfranc Injury
What is a Lisfranc Injury (2)?
Fracture AND dislocation of 1st and 2nd TMT
What condition involves mid foot pain and is dx with an XR WITH WB?
Lisfranc Injury
What sxs is seen with a Lisfranc Injury, and what is the recommended dx test?
Mid foot pain
- Dx with XR WITH WB
What is often the recommended tx for a Lisfranc Injury?
Surgery
What condition involves MOI is high impact (ex. fall from high height)?
Calcaneus Fracture
What body part is most commonly affected with Compartment Syndrome, and what specific section?
Lower leg
- Anterior compartment
What condition involves the 6 P’s and what are they?
Compartment Syndrome
- PAIN (out of proportion)
- Paresthesias
- Pallor
- Pulselessness (late)
- Poikilothermia (late)
- Paralysis (late)
What condition involves PAIN OUT OF PROPORTION, often paresthesias and pallor?
Compartment Syndrome
What is the dx of Compartment Syndrome?
CLINICAL
- Dx that shit and get treatin
What is the recommended tx for Compartment Syndrome, and WHY?
Fasciotomy
- To relieve pressure (at least the answer for this one was actually in the slides :))
What tx should be considered for Compartment Syndrome IF late dx (8+ hours)?
Amptutation
What condition involves irreversible cartilage destruction?
Septic Arthritis
What is the most common joint affected with Septic Arthritis in adults?
Knee
What pathogen is most commonly seen with Septic Arthritis? What other pathogen may be seen in conjunction?
What pathogen is second most common?
Staphylococcus aureus +/- MRSA
- Strep = 2nd
What dx test is gold standard for Septic Arthritis?
PROMPT arthrocentesis
With Septic Arthritis in PEDS, which two joints are most often affected?
- Knee
- Hip
If the hip is affected by Septic Arthritis in PEDS, what PE finding will be seen?
FABER position
What is the most common cause of PEDS hip pain?
Septic Arthritis
