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Emergency Medicine > LE Surgery > Flashcards

LE Surgery Flashcards

1
Q

50% of pelvic fx are a/w _____

A

internal injury

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2
Q

what is a low-energy MOI and population for pelvic fx?

A

falls in elderly

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3
Q

What must be included in H & P with pelvic fx?

A

rectal/genital

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4
Q

Gold standard imaging for pelvic fx

A

CT

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5
Q

Bedside US can be helpful in what pelvic fx patients?

A

blunt trauma

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6
Q

What 4 views on X-Ray for pelvic fx

A

AP, Judet, Inlet, Outlet

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7
Q

MC pattern of pelvic fx…

A

posterior wall fx w/ femoral head dislocation

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8
Q

avulsion fx of pelvis is more common in what population?

A

skeletally immature athletes

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9
Q

Pelvic ring is unstable with how many fx?

A

2

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10
Q

pelvic fx intervention if hemodynamically unstable…

A

pelvic wrapping/binder

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11
Q

conservative tx of pelvic cx…

A

restricted weight bearing

ice

rest

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12
Q

surgical intervention for pelvic fx

A

ORIF/external fixation

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13
Q

major complication of hip dislocation

A

femoral head death

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14
Q

maintain survival of femoral head, reduction of hip dislocation must be performed w/in…

A

6-8 hours

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15
Q

what percent of hip dislocations also have other injuries

A

80-90%

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16
Q

MOI of hip dislocation

A

high energy trauma

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17
Q

90% of hip dislocations are…

A

posterior

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18
Q

complex dislocation means…

A

dislocation + fx

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19
Q

Pt. presents with:

pain
nwb
one leg shorter
fixed in adduction and internal rotation

A

hip dislocation

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20
Q

NV check on hip dislocation should be focused on…

A

sciatic nerve

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21
Q

MC hip dislocation reduction technique…

A

Allis maneuver

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22
Q

Pain in groin, radiates to inner thigh

difficulty with flexion, internal rotation

leg held in external rotation/abduction

A

proximal femoral fx

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23
Q

why CT in proximal femoral fx?

A

evaluate displacement

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24
Q

2 views of x-ray for proximal femoral fx?

A

AP/Lat, Full femur (incl knee joint)

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25
4 complications of proximal femoral fx...
AVN infx DVT/PE nonunion
26
proximal femoral fx requires prophylaxis for...
DVT
27
2 populations for femoral shaft fx and mechanisms...
young men = severe trauma elderly women = falls
28
Pt. p/w: obvious femoral deformity nwb lost of ROM
femoral shaft fx
29
2 x-ray views for femoral shaft fx...
AP/Lat
30
what can be life threatening in femoral shaft fx?
blood loss
31
3 complications of femoral shaft fx...
malunion/nonunion infx hardware pain
32
______ is a surgical emergency with high incidence of neurovascular injury...
knee dislocation
33
MC MOI for posterior knee dislocation
dashboard injury
34
What knee dislocation? MC MOI = hyperextension
anterior
35
what nerve is MC associated with knee dislocation? artery?
peroneal n. popliteal a.
36
x-rays for knee dislocation
pre-post reduction AP/lat
37
CT can better define _____ following knee dislocation reduction
fx
38
_____ is needed following hardware placement to assess for soft tissue involvement
MRI
39
knee dislocation often requires..
ortho fixation
40
splinting of knee location at ____ degrees of flexion
20 degrees
41
important facet of knee dislocation mgmt...
serial NV assessments
42
patellar dislocations are typically which direction?
lateral
43
MOI for patellar dislocation
twist on flexed knee
44
pt. p/w: knee "gives way" + severe pain knee fixed in 20-30 degrees of flexion
patellar dislocation
45
reduction technique for patellar dislocation...
supine w/ hip flexion gradually increase knee extension w/ medial pressure on patella
46
radiographs (3) for patellar dislocation...
AP/Lat, sunrise
47
post-reduction mgmt of patellar dislocation
RICE, NSAIDs +/- muscle relaxant/narcotics
48
what fx? MOI = direct force in knee flexion indirect force with extreme contraction of quads
patellar fx
49
Patient p/w: knee effusion hemarthrosis inability to extend knee
clinical presentation
50
imaging for patellar fx
AP/Lat, sunrise view
51
splinting for patellar fx
full extension, nwb
52
non-surgical mgmt of patellar fx
extension cylinder casting | locked extension brace
53
when is surgery indicated for patellar fx...
displaced or complex fx
54
concominant injuries w/ tibial plateau fx (2)
meniscus, ligament
55
pt. p/w: localized pain and swelling to LE knee effusion restricted ROM, pain w. WB
tibial plateau fx
56
3 radiograph views for tibial plateau fx
AP, Lat, intercondylar notch
57
if x-ray inconclusive but still suscpicious of fx, what imaging?
CT
58
what position to splint tibial plateau fx?
full extension
59
how long nwb with tibial plateau fx?
6 weeks
60
which 2 are unstable malleolar fx?
bimalleolar, trimaleolar
61
Ottawa Ankle Rules: if malleolar tenderness and 1 of the below, what is indicated? - posterior fibular pain - posterior distal tibia pain - nwb
ankle films
62
Include foot films if midfoot pain and 1 of what 3?
navicular pain 5th MT base pain nwb
63
ankle series x-ray
AP/Lat, mortise
64
3 immobilization options for ankle fx
splinting, brace, CAM boot
65
MC MT fx in adults...
5th MT
66
metaphyseal-diaphyseal junction fx of 5th MT...
jones fx
67
jones fx has risk of...
nonunion
68
proximal tubercle of 5th MT fx
pseudo-jones/avulsion
69
3 x-rays for MT fx
AP, lateral, oblique
70
2 conservative tx of MT fx
rigid shoe, CAM boot
71
jones fx, delayed union or unstable fx treatment options
casting/surgery
72
A fx or dislocation of 1st and 2nd TMT...
lisfranc fx
73
low energy mechanism of lisfranc fx
stepping off curb into hole
74
high energy moi for lisfranc fx
MVA, fall from height
75
lisfranc fx present with pain where?
midfoot
76
x-ray views for lisfranc fx
AP weight bearing bilateral feet, lateral, oblique
77
which x-ray view for lisfranc fx? -medial margin 2nd MT and middle cuneiform alignment
AP
78
which x-ray view for lisfranc fx? dorsal margin 1st and 2nd metatarsal and cuneiform alignment
lateral
79
which view for liscranc fx base of 4th metatarsal and cuboid alignment
oblique view
80
lisfranc requires surgery if > ___mm
2mm
81
most helpful view for calcaneal fx
lateral
82
tx for calcaneal fx is typically casting and nwb... surgery is needed if...
displacement
83
MC region of compartment syndrome
lower leg, anterior compartment
84
high energy trauma and crush injuries are at high risk of...
compartment syndrome
85
6 Ps of compartment syndrome
``` paresthesia pallor pulseless poikilothermia paralysis ```
86
intra-compartmental pressue isn't always necessary, but > ___ mmHg is concerning and warrants fasciotomy
30 mmHg
87
Tx for compartment syndrome if dx within 8 hours...
dermato-fasciotomy
88
tx for late finding compartment syndrome...
amputation or fasciotomy (high risk infx)
89
4 complications of acute compartment syndrome
infx amputation volkmann's contracture rhabdo
90
MC agent of septic arthritis
staph aureaus
91
MC peds septic arthritis
knee/hip
92
a pediatric patient in the FABER position is concerning for...
septic arthritis of hip
93
gold standard diagnostic for septic arthritis
arthrocentesis
94
radiographs show: increased joint space or narrowing
septic arthritis
95
use of US in septic arthritis...
detect effusion/guide aspiration

Emergency Medicine (12 decks)

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