Lecture 2-4 (Trauma) Flashcards
What is the outer layer of bone called
cortex
What is the end of bones called?
metaphyseal
dense and strong in the shaft area
cortex
cortex is thinner, and bone underneath is not dense or strong?
metaphyseal area
Bone underneath thin cortical shell
cancellous bone
2/3 blood supply to diaphysis
internal (endosteal)
1/3 blood supply to diaphysis
external (periosteal)
Metaphyseal blood supply
endosteal and periosteal vessels and soft tissues
What happens when breaks or fractures occur?
soft tissue and muscle damage, blood supply disruption
What breaks under very little deformation
bones
Mother Nature Cast
Indirect bone healing
Compressing the fracture fragments together
Direct bone healing
No callus can be seen on xray
direct bone healing
Callus forms in the area of the fracture
indirect bone healing
Most dislocations of the shoulder are…!
anterior
What are shoulder dislocations caused by?
abduction
extension
external rotation
What is at risk in a shoulder dislocation?
axillary nerve (scratch deltoid)
What is the key to any reduction?
relaxation and muscle fatigue
How to reduce a shoulder dislocation?
pre and post reduction NV exam
What is the txt for shoulder dislocation?
sling for 1-2wks, w/ gentle progressive ROM exercises and thxp
What two muscles are involved in shoulder dislocations?
subscapularis
biceps
T/F Posterior dislocations are rare
TRUE!!! (5%)
What is MOST common cause for a posterior shoulder dislocation!!?
seizure
electric shock
What is the most common physical exam finding for a posterior shoulder dislocation
shoulder locked in internal rotation
What is a Bankart lesion?
injury of anterior (inferior) glenoid labrum of the shoulder
“Coffee cup on a plate” and humerus slides off
Bankart lesion
Humerus head slides out and bangs into the glenoid rim, causing a indentation
Hill- Sachs lesion
cortical depression in the posterolateral head of the humerus bone
Hill-Sachs lesion
Often the result of a fall on an outstretched hand
Glenoid fracture
When are glenoid fractures repaired?
greater than 25 percent of the joint surface
Where are most clavicle fractures seen?
middle 1/3 (80%)
What is the most common cause for clavicle fractures?
Traffic accidents (70%) (seat-belt)
Txt for anterior proximal 1/3 clavicle fracture?
exclusively NON OP
Rec CT scan to check neuro and SC joint
Txt for middle 1/3 clavicle fracture?
mostly NON-OP
Txt for distal 1/3 clavicle fracture?
mostly non-op BUT controversial (SURGERY)
mostly likely NON-UNION
2% clavicle fracture?
proximal 1/3
Associated w/ direct trauma (bat, crowbar)
Scapula fracture
Txt for scapula fracture?
managed non-op
Part of the scapula most commonly fractured?
body and spine
What is comminution?
bone broken into a million little pieces
Operative indication of a scapula fracture?
- Significant displacement of the glenoid cavity
- Significant displacement of the glenoid neck
- Comminution
- Very very rare to require fixation
