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Int Spec (Ortho) > Lower Limb Trauma > Flashcards

Lower Limb Trauma Flashcards

1
Q

To maximise the chance of restoration of function and to promote early mobilisation, almost all hip fractures undergo surgical management within what timeframe?

A

24 hours

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2
Q

What typically happens to the affected limb in individuals with a hip fracture?

A

The limb is shortened and externally rotated

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3
Q

Individuals with a hip fracture will have severe pain where?

A

The groin

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4
Q

How can an intracapsular hip fracture be recognised on an x-ray?

A

A break in Shenton’s line

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5
Q

Which subtype of hip fracture has a higher risk of disruption to the arterial supply of the femoral head, and hence a higher risk of AVN?

A

Intracapsular

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6
Q

How should an undisplaced, intracapsular hip fracture be treated in a healthy individual with no or minimal co-morbidities?

A

Internal fixation

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7
Q

How should an undisplaced, intracapsular hip fracture be treated in an individual with major illness or advanced organ specific disease?

A

Hemiarthroplasty

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8
Q

How should a displaced, intracapsular hip fracture be treated in an individual with no or minimal co-morbidities aged < 70 years?

A

Internal fixation

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9
Q

How should a displaced, intracapsular hip fracture be treated in an individual with no or minimal co-morbidities aged > 70 years?

A

Total hip replacement

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10
Q

How should a displaced, intracapsular hip fracture be treated in an individual who has major comorbidities or or is immobile?

A

Hemiarthroplasty

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11
Q

How should an extracapsular hip fracture (no special type) be treated?

A

Dynamic hip screw

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12
Q

How should an extracapsular hip fracture (reverse oblique, transverse or subtrochanteric) be treated?

A

IM device

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13
Q

What must be assessed after a patient has been treated for a hip fracture?

A

Calcium and vitamin D levels +/- DEXA scan

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14
Q

What system can be used to classify hip fractures?

A

Garden system

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15
Q

Following resuscitation and optimisation of analgesia, what can be used to stabilise a femoral shaft fracture before definitive treatment is initiated?

A

Thomas’ splint

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16
Q

How is a femoral shaft fracture usually treated definitively?

A

Closed reduction and fixation with an IM nail

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17
Q

In tibial shaft fractures with up to 50% displacement and 5 degrees of angulation, treatment can be conservative. What does this involve?

A

Above knee casting

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18
Q

In tibial shaft fractures with more than 50% of displacement and 5 degrees of angulation, treatment is surgical. What does this involve?

A

Closed reduction and internal fixation with an IM nail

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19
Q

Tibial shaft fractures can take up to how long to heal?

A

One year

20
Q

What are Pilon fractures and how are they treated?

A

Intra-articular fractures of the distal tibia- treat with ORIF

21
Q

What is the mechanism of injury for most ankle injuries?

A

Inversion injury

22
Q

According to the Ottawa rules, an x-ray is required for an ankle injury if there is pain in the malleolar zone, and one of what other findings?

A

Bony tenderness over the medial or lateral malleolus, or the inability to weight-bear for four steps

23
Q

How are isolated distal fibular fractures with no medial fracture or rupture of the deltoid ligament treated?

A

Walking cast or splint for 6 weeks

24
Q

How are distal fibular fractures with rupture of the deltoid ligament treated?

A

ORIF with plates and screws

25
Q

How is rupture of the deltoid ligament in the ankle suspected on clinical examination?

A

Medial bruising and tenderness

26
Q

How is rupture of the deltoid ligament in the ankle suspected on x-ray imaging?

A

Talar shift (asymmetric increased space around the talus)

27
Q

Virtually all patellar dislocations are in what direction?

A

Lateral

28
Q

Who are patellar dislocations most commonly seen in?

A

Adolescent females

29
Q

Why do patients with a patellar dislocation have pain over the medial retinaculum?

A

The medial patello-femoral ligament is torn

30
Q

A lipo-haemarthrosis is seen in which traumatic injury to the lower limb?

A

Patellar dislocation

31
Q

What is the risk of a second patellar dislocation?

A

10%

32
Q

What is the best x-ray view for assessing the ankle?

A

AP-mortise view

33
Q

What is the most common subtype of intracapsular hip fracture?

A

Subcapital

34
Q

Injury to what artery and nerve may occur in association with a femoral shaft fracture?

A

Femoral artery and sciatic nerve

35
Q

What is the usual mechanism of action for a posterior hip dislocation?

A

Front seat passenger, knee strikes dashboard

36
Q

How will the limb appear following a posterior hip dislocation?

A

The limb is shortened and internally rotated

37
Q

If a fracture is not seen on AP and lateral x-rays but the patient cannot weight bear, what investigation should be done next?

A

MRI

38
Q

Twisting of the lower leg with quadriceps contraction describes the mechanism of what injury?

A

Patellar dislocation

39
Q

Post-reduction of a patellar dislocation, what should be done?

A

Assessment of the extensor mechanism and x-ray to assess for a fracture

40
Q

What are the two main mechanisms of injury for a patellar fracture?

A

Fall onto a flexed knee or dashboard injury

41
Q

85% of ankle sprains are due to injury to what structure?

A

Anterior talo-fibular ligament

42
Q

What would make an ankle sprain be considered ‘severe’ and require below knee immobilisation for at least 10 days?

A

Inability to weight bear

43
Q

How should a mild ankle sprain be treated?

A

Rest, ice, compression, elevation

44
Q

If an individual has a calcaneal fracture following a fall from height, what other injury should be actively looked for?

A

Spinal fracture

45
Q

What is the primary imaging investigation in all polytrauma patients?

A

CT

Int Spec (Ortho) (10 decks)

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