Lower limb fractures

Question 1

NOF #
can be classified as […]- or […]-capsular,
-[…]-capsular femoral fractures can compromise the […] vessels- leading to […] […] of the femoral head.

Answer 1

extra, intra
intra, retinacular, avascular necrosis

Question 2

Classification used for intracapsular NOF#

Answer 2

Garden

Question 3

Garden
Type I: […] fracture with impaction in […]
Type II: […] fracture but […]
Type III: […] fracture, usually rotated and angulated, but still has […] contact
Type IV: Complete boney […]

Answer 3

Type I: Stable fracture with impaction in valgus
Type II: Complete fracture but undisplaced
Type III: Displaced fracture, usually rotated and angulated, but still has boney contact
Type IV: Complete boney disruption

Question 4

Mx hip intracapsular #
Undisplaced - […]
–> if unfit –> hemiarthroplasty

Displaced
—> […] or hemiarthroplasty

Hemiarthroplasty in […] patients who are not […], are […] impaired or not […] […] for THR

Answer 4

Undisplaced - ORIF
–> if unfit –> hemiarthroplasty

Displaced
—> THR or hemiarthroplasty

Hemiarthroplasty in older patients who are not mobile, are cognitively impaired or not medically fit for THR

Question 5

Mx HIP extracapsular #

• Intertrochanteric - […] […] […]
• Infratrochanteric - […][…] […]

Answer 5

Intertrochanteric - dynamic hip screw
- Infratrochanteric - IM nail

Question 6

Tibial plateau #
occur as a result of […] energy impact.

Diagnosis is via plain x-ray. Plateau fractures may be managed […] with immobilisation in a […] […] […] for 8-12 weeks.

Displaced or open fractures may require surgical fixation.

Answer 6

high

conservatively, hinged knee brace

Question 7

Tibial shaft #
[…] injury or direct force to the leg

Symptoms typically include inability to […] […], […], and deformity. Diagnosis is via plain […]-[…]. Management includes non-operative ([…] and […]) or via surgical reduction and fixation via […] […] or […] […].

Common complications of tibial shaft fractures include […] […], and […] compromise.

Answer 7

torsional

Symptoms typically include inability to weight bear, pain, and deformity. Diagnosis is via plain x-ray. Management includes non-operative (reduction and cast) or via surgical reduction and fixation via intramedullary nailing or external fixation.

Common complications of tibial shaft fractures include compartment syndrome, and neurovascular compromise.

Question 8

Classification for lateral malleolar fracture

Answer 8

Weber

Question 9

Rules to determine if XRAY is required for ankle or not

Answer 9

Ottawa

Question 10

Weber classification for alteral malleolus

Answer 10

Type A - below syndesmosis
Type B - at level of syndesmosis
Tycpe C - above syndesmosis + torn syndesmosis

Question 11

Ottawa rules
Pain in […] zone and:
1. Inability to […] […] for […] steps
2. Tenderness over the […] […]
3. Bone tenderness over the […] […]

Answer 11

Pain in malleolar zone and:
1. Inability to weight bear for 4 steps
2. Tenderness over the distal tibia
3. Bone tenderness over the distal fibula