Lower Extremity Fractures

Question 1

What is a Pott’s fracture?

Answer 1

Fracture fibula higher up

Damage tibiofibular syndesmosis inferior

Fracture of either one or both malleoli

Question 2

What is a trimalleolar fracture?

Answer 2

Fracture to both malleoli and the posterior inferior tibia

Question 3

What is a maisonneuve fracture?

Answer 3

Damage to deltoid ligament & tibiofibular inferior syndesmosis

Fracture proximal fibula

Unstable ankle ~ widening of ankle mortise

+/- fracture medial malleolus

Question 4

What are the 2 kinds of ankle sprains & what ligaments do they damag?

Answer 4

Inversion ~ calcaneofibular lig., anterior talofibular lig., posterior talofibular lig.

Version ~ deltoid ligament

Question 5

What are the Ottawa ankle & foot rules?

Answer 5

Pain in the malleolar region & only one of these things OR pain in the mid foot & only one of these things

1) bone tenderness at the bae 5th metatarsal
2) bone tenderness at the navicular
3) bone tenderness at the posterior tip of the medial malleolus
4) bone tenderness at the posterior tip of the lateral malleolus
5) inability to weight bear immediately & <4 steps in ED

Question 6

What are the 3 types of hip fractures?

Mechanism?

Complications

Features?

Answer 6

Femoral neck, intertrochanteric, subtrochanteric

All same mechanism ~ fall from standing or rotational force from tripping

Femoral neck fracture ~ risk of avascular necrosis bc of the a. Of the ligament up of teres being cut off
Other risks same: arthritis, non-union, dislocation

Features: femoral neck ~ groin pain & min. bruising, intertrochanteric & subtrochanteric ~ ecchymoses on the posterior thigh