Lower Extremity Emergencies -- SD Flashcards
What is the common cause of pelvic fractures?
Blunt trauma
What is the only stable type of pelvic fracture?
Ramus
If you are suspecting a pelvic fracture, what do you look for on exam?
Crepitus, instability, ability to bear weight, rotation
What population is at risk for hip fractures?
elderly and osteoporotic women
Where are the most common hip fractures?
Femoral head, surgical neck, intertrochanteric, and subtrochanteric
How do hip fractures typically present?
leg pain – leg shortened and externally rotated
Do we admit hip fractures?
yes! all get admitted, foley catheter, and pain control
Do more hip locations occur before or after joint replacements?
After – vast majority due to non-native joint
Most common cause of hip dislocations?
MVA
Do hips dislocate anteriorly or posteriorly?
Posterior
On physical exam, a hip dislocation will have a shortened leg and will be ________ rotated
internally
Do patients with a femur fracture typically walk in to the ER?
No – this not a subtle injury. Severe pain!
When kids present with big bone fractures, what do you need to make sure to rule out?
Abuse
How do we treat femur fractures?
surgery – always
Pain out of proportion to exam – knee injury – what is it?
Tibial Plateau Fracture
How do we diagnose a tibial plateau fracture?
CT scan of the knee
Can patients walk with an ACL tear?
yes
How will patients with an ACL tear present?
Lax ligament, swollen knee
Positive anterior drawer test
What test on physical exam do we perform to diagnose an MCL/LCL tear?
Valgus/Varus force
What test do we do on physical exam to diagnose a meniscus tear?
McMurrary’s
What do we do if a patient presents with knee dislocation?
don’t touch it – call ortho
What are knee dislocations so serious?
High risk of neurovascular problems
How will a quad tendon rupture present?
Can’t extend their leg at the knee
Where do most fibular fractures occur?
Lateral malleolus
How do most fibular fractures occur?
Usually second to inversion injuries
What is a masionneurve injury?
When the distal fracture in the fibula radiates up, spirals, and break the proximal fibula
how do we treat a fibular fracture?
splint/non-weightbearing
refer to ortho
What what must we look for on x-ray of a bimalleolar/trimalleolar injury?
Mortise disruption (widened mortise)
Do we admit patients for a bi/trimalleolar fracture?
Yes!
What test do we do on PE to diagnose an Achilles tendon rupture?
Thompson’s test – squeeze calf and nothing happens
How do we treat an Achilles tendon rupture?
Splint in full plantar flexion and surgery
This injury typically occurs when someone falls from height and lands on their feet
Calcaneal injuries/fracture
