lower limb fractures Flashcards
ankle stability - involvement of what causes instability? (4)
- medial malleolus / deltoid ligament
- lateral malleolus
- posterior malleolus
- syndesmosis ligament
what is used to classify ankle fractures
weber
A = below syndesmosis
B = at syndesmosis
C = above syndesmosis
what does talar shift mean
loss of 4mm on medial side of ankle joint
what is management of weber C fracture
ORIF + syndesmosis screw
management of complex tibia / fibular fractures
external fixator
ilizaov frame
assessment of tibial and femoral fractures? what is important to check for?
NV - pulses
shock, fat embolism
split ASAP - Thomas / backstab
imaging of tibial / femoral fractures?
xray ap and lateral
joint above and below!
complications of tibial / femoral fracture? 3
fat embolism
shock
compartment syndrome
DVT / PE
management of tibial fracture (displaced)
IM nail (I - IIIa) external fixator IIIb ORIF IIIc
treatment of open fracture
IV co amoxiclav early
take to theatre ASAP for washing, debridement, stabilisation
symptoms of compartment syndrome? difference between deep posterior and anterior?
deep posterior = weak toe flexion, pain on passive toe extension, loss of sensation sole of foot
anterior = weak toe flexion, pain on passive toe extension, loss of sensation 1st web space
treatment of compartment syndrome?
urgent fasciotomy
management of femoral fracture
IM nail (commonest) ORIF
signs of fat embolism
asymptomatic for 12-28h
respiratory failure
tachycardia, tachypnoea ,hypoxemia, hypocapnia, thrombocytopenia
petechial rash (late)
name of ligament between medial cuneiform and base 2nd MTP
lisfranc ligament
