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emergency med final > lower extremity orthopaedics > Flashcards

lower extremity orthopaedics Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

classify physis (growth plate) fracture

A
  • salter-harris
    • I: Seperate
    • II: Above
    • III: Lower
    • IV: Through
    • V: Reduced
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2
Q

what type of fx is this

A
  • Torus or “buckle” fracture
    • unique to children
    • looks like compacted soda can
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3
Q

what type of fracture is this

A
  • greenstick fracture
    • fracture of the bone, occurring typically in children, in which one side of the bone is broken and the other only bent.
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4
Q

what type of fracture is this

A

oblique fx

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5
Q

describe fracture

A
  • transverse and bayoneted fx
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6
Q

describe fracture

A

comminuted fx

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7
Q

CRPPF surgery

A

closed reduction percutaneous pin fixation

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8
Q

ORIF surgery

A
  • open reduction internal fixation
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9
Q

50% of pelvic fractures are associated with

A
  • internal injuries
    • vascular hemorrhage
    • intraabdominal, bladder, aortic injuries
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10
Q

gold standard for diagnosing pelvic fracture

A
  • CT scan
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11
Q

most common type of pelvic fracture

A
  • posterior wall fx with possible associated femoral head dislocation
  • avulsion fx in skeletally immature athletes
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12
Q

most hip dislocations are ? How will the patient present

A
  • posterior dislocations
  • adduction and internal rotation of affected leg
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13
Q

how do anterior dislocations present

A
  • slight abduction and external rotation
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14
Q

complications of hip dislocation

A
  • sciatic nerve damage
  • avascular necrosis
  • arthritis
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15
Q

clinical presentation

  • pain to groin and radiates to inner thigh
  • difficulty with flexion and internal rotation
  • will hold leg in external rotation/abduction
  • leg may appear shorter
A

hip fracture

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16
Q

imaging if you suspect hip fracture

A
  • plain radiographs: AP/lateral
  • CT
  • MRI if high suspicion and neg xrays
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17
Q

describe intracapsular hip fracture. adverse effect of this injury

A
  • neck/head of femur within capsule
  • avascular necrosis
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18
Q

describe an intertrochanteric hip fracture

A
  • between neck and lesser trochanter
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19
Q

describe subtrochanteric fracture

A
  • below lesser trochanter
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20
Q

important to give patient this medication for hip fracture

A
  • prophylaxis for DVT
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21
Q

septic hip and transient synovitis peak presentation

A
  • neonates
  • 3-6 y.o
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22
Q

transient synovitis is often caused by a viral infection and often associated with a

A
  • recent illness
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23
Q

leg position typical of septic hip

A
  • hip flexed, externally rotated and abducted
24
Q

criteria to differentiate transient synovitis and septic hip

A
  • Kocher criteria
    1. WBC > 12,00
    2. ESR > 40
    3. Fever > 101.3
    4. non weight bearing on affected side
  • 2/4 warrants joint aspiration
25
Q

what image modality is preferred if diagnosis of septic hip is questionable or surgery is scheduled

A

MRI

26
Q

another way to help differentiate between septic hip and transient synovitis is the administration of this medication

A
  • NSAIDS
    • ​transient synovitis will improve with NSAIDS
27
Q

how is septic hip diagnosed

A
  • joint aspiration
28
Q

describe slipped capital femoral epiphysis (SCFE)

A
  • slippage of femoral epiphysis on the femal metaphysis
    • ice cream falling off cone
29
Q

typical patient population associated with slipped capital femoral epiphysis (SCFE)

A
  • obese, adolescent males
  • african american
30
Q

clinical presentation

  • pain: hip, thigh, knee
  • limp or NWB
  • abduction and internal rotation
A

slipped capital femoral epiphysis (SCFE)

31
Q

management of slipped capital femoral epiphysis (SCFE)

A
  • emergent surgery
32
Q

typical patellar dislocation location

A
  • lateral dislocation
    • MOI: twisting on flexed knee
33
Q

imaging for patellar dislocation

A
  • not necessary prior to reduction
  • immediate reduction required
34
Q

largest sesamoid bone

A
  • patella
    • improved knee extension
35
Q

clinical presentation

  • direct force in knee flexion
  • knee effusion
  • inability to extend knee
A

patellar fracture

36
Q

managment of patellar fracture

A
  • splint in full extension
  • NWB
  • eventual PT
  • surgery for complex or displaced fx
37
Q

what concomitant injuries are likely with tibial plateau fracture

A
  • meniscus
  • ligament injury
38
Q

radiograph views for tibial plateau fracture

A
  • AP
  • lateral
  • intercondylar notch view
39
Q

treatment of tibial plateau fracture

A
  • splint in full extension
  • NWB
  • ortho consult
40
Q

most common cause of proximal tibia fracture in children

A

trampoline

41
Q

complication of proximal tibia fracture

A
  • post-traumatic bowing
42
Q

tibial shaft fractures have a high risk for

A
  • anterior compartment syndrome
43
Q

what is a toddlers fracture

A
  • pediatric tibia shaft fx
    • common cause: child falling while running often with twisting mechanism
44
Q

how is toddlers fracture diagnosed and treated

A
  • often clinical diagnoses
  • tx: cast
45
Q

triplane fracture

A
  • seen in adolescents
  • a vertical fracture through the epiphysis
  • a horizontal fracture through the physis
  • an oblique fracture through the metaphysis
46
Q

MOA for 5th metatarsal fx

A
  • inverson
47
Q

describe avulsion fx of 5th metatarsal

A
  • peroneus brevis inserts on base of 5th MT
  • avulsion along lateral tuberosity
48
Q

describe jones fracture

A
  • base of 5th metatarsal at the metaphyseal/diaphyseal junction
49
Q

stress fractures are most common in what metatarsal

A
  • 3rd MT
50
Q

tx of jones fx

A
  • surgery due to slow healing
51
Q

tx of stress fx and avulsion metatarsal fx

A
  • conservative tx
    • cast vs CAM boot
52
Q

what is a Lisfranc fracture

A
  • fx of 1st and 2nd tarsal metatarsal
    • MOI: step off curb or into hold, fall from high height
53
Q

imaging if you suspect a Lisfranc fracture

A
  • AP WB BL feet
  • lateral radiographs
  • early recognition important
54
Q

achilles tendon is common insertion site for

A
  • gastrocnemius/soleus
55
Q

test for achilles tendon rupture

A
  • thompson test

emergency med final (4 decks)

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