LOCO Anatomy2b Flashcards
What is the definition of displacement? [1]
Amount of movement from anatomical position
Displacement is described in relation to which section of the fracture or dislocation? [1]
Distal fracture fragment
State what type of fracture this is [1]
Communicated: term comminuted fracture refers to a bone that is broken in at least two places
What type of fracture is depicted? [1]
Avulsed: a failure of bone in which a bone fragment is pulled away from its main body by soft tissue that is attached to it
A 16-year-old boy falls and lands on his outstretched right forearm sustaining an uncomplicated distal radius fracture with dorsal displacement consistent with a “dinner fork deformity.” Which of the following is the best initial management for this patient?
A. Open reduction and internal fixation
B. Reduction and splint
C. Thumb spica cast
D. Long arm cast
B. Reduction and splint: Treatment of uncomplicated distal radial fractures is the conversion of the splint to a short arm cast for 6 to 8 weeks.
A 63-year-old woman presents after slipping on ice and landing on her left outstretched hand. She reports that her left wrist is painful and began to swell a few hours ago. Examination of the left wrist demonstrates a typical dinner fork deformity and volar wrist bruising. Sensation and motor power of the radial, ulnar, and median nerves are intact, and there are palpable radial pulsations. Radiographs are most likely to show which of the following?
A. Distal radius dorsally angulated fracture
B. Radial head Mason type II fracture
C. Galeazzi fracture-dislocation
D. Monteggia fracture dislocation
A. Distal radius dorsally angulated fracture
A 26-year-old man presents with a painful and swollen left ankle after he tripped over a step and fell. On examination, he can fully weight-bear. The left ankle is swollen, but there is no bruising, medial ankle tenderness, or distal neurovascular deficits. A radiograph of the left ankle is most likely to show which of the following?
A. Weber A fracture
B. Pilon fracture
C. Medial malleolus avulsion fracture
D. Weber C trimalleolar fracture
A. Weber A fracture
A 14-year-old male presents after sustaining an injury to his leg while playing basketball. During the exam, he becomes very agitated and exhibits pain out of proportion to the exam. He reports a tingling sensation distal to his injury and is found to have severe swelling of the injured area and loss of distal pulses. Which avulsion injury is most at risk for developing this complication?
A. Glenoid rim avulsion fracture
B. Segond fracture
C. Ischial tuberosity avulsion fracture
D. Tibial tubercle avulsion fracture
D. Tibial tubercle avulsion fracture
What does the term ‘reduction of a fracture’ mean? [1]
Process undertaken by orthopaedic surgeons to realign the bony fragments, returning the fractured bone to anatomical position
Describe what a closed reduction is [1]
Describe how a closed reduction is performed [1]
Closed reduction:
* when skin and soft tissue is left intact
* Apply traction and opposing force to the displaced fracture segment to realign the bone and the stabilising it in anatomical position
Describe the angulation of a Colles fracture [1]
Dorsally angulated fracture
Which nerve is commonly damaged in a Colles fracture? [1]
Median
Describe the blood supply to the femoral epiphysis in children and how this differs to the blood supply to the femoral head in adults [2]
Children: round ligament artery which is found in the ligamentum teres
What are the major risks associated with open fractures? [3]
Infection
Compartment syndrome
Risk of neurovascular damage
What are two key steps in minimising major risks associated in patients management? [2]
Give IV antibiotics; tetanus; analgesia
Washout and debridement ASAP
What landmarks are used to assess the:
Dorsalis pedis [1]
Posterior tibial [1]
Dorsalis pedis
* Lateral to extensor hallicus longus
Posterior tibial
* Posterior to medial malleolus
Label A-D
A: Posterior tibiofibular ligament
B: Anterior tibiofibular ligament
C: Achilles tendon
D: Calcaneofibular ligament
Label 1-3
1: Anterior tibiofibular ligament;
2: Bassett’s ligament;
3: anterior talofibular ligament
Label A-C
A: Calcaneous
B: Talus
C: navicular
Label A & B [2]
A: Calcaneous
B: Talus
Label 1-4
- Deltoid ligament. 2. Medial malleolus. 3. Medial talar process. 4. Posterior tibial tendon (cut)
Which classification system is used to assess distal fibula fractures [1]
Webers classification
Describe the difference between the locations of Type A, B & C Weber Fractures [3]
State if each type is stable / unstable
Type A:
* Fibular fracture below level of syndesmosis
* stable
Type B:
* Fibular fracture at level of syndesmosis
* stable or unstable
Type C:
* Fibular fracture above level of syndesmosis
* unstable
State the treatment for Type A, B & C Weber fractures [3]
Type A: conservative management: cast and weight bearing
Type B: conservative management: cast and weight bearing OR surgical fixation: plate and screws
Type C: surgical fixation plate and screws
What type of Webers fracture is this? [1]
A: below the syndesmosis
What type of Webers fracture is this? [1]
B: level of syndesmosis
What type of Webers fracture is this? [1]
C: above
