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MJ- Disciplines Exam 3 > luis- Fractures > Flashcards

luis- Fractures Flashcards

1
Q

What fracture occurs commonly at the middle area (75%)

A

Clavicle

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2
Q

Whats the MOI of a clavicular fracture

A

a fall with the arm to the side

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3
Q

who is most at risk of a clavicular fx?

A

women, over 60s, and udner 30s

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4
Q

What fx has Crepitus and tenting of the skin?

A

Clavicular Fx

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5
Q

What are the images needed for a Clavicular Fx?

A

AP, Lateral and 45 degree tilt

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6
Q

Can a patient externally/internally rotate their arms with a clavicular fx?

A

Yes, Not with a humoral head fx

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7
Q

How can you tx a clavicular fx

A

Non-operative: Sling or figure 8 (better posture)

Surgical: Open, Neurovascular (N,O) Tenting

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8
Q

When do you surgically repair a clavicular fracture?

A

Dominant arm of an athlete, Wide displacement, displacement is >1/3 fx

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9
Q

MOI of a humorus head?

A

Fall on oustreched hand (FOOSH) more common in over 60 yo and female

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10
Q

How can you classify a humoral head fx?

A

Neers

1) fx w/ <1 cm of displacement
2) fx w/ >1 cm of displacement
3) Many fractures w/ >1 cm displacement
4) Surgical neck + lesser tuberosity + Greater tuberosity

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11
Q

What images do you order for a humoral head fx?

A

Lateral, AP, Y view (LAY)

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12
Q

How can you tx a humorus head fracture?

A

Non surgical: Neers 1

Surgical: Neers 2, Bicipital groove alteration, N, O

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13
Q

MOI of Mid humorus Fx

A

FOOSH, bending force on humerus

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14
Q

What do you suspect if a Peds pt presents with a mid humorus fx?

A

Child abuse

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15
Q

What nerves are can be damaged in a mid humorus fx?

A

MC = Radius (sensory: dorsum of hand. Motor: Wrist flexion)
Median (sensory: palm, thumb, 1st 3 fingers. Motor: thumb opposition)
Ulnar (sensory: little finger. Motor: finger abduction)

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16
Q

How do you do a vascular scrn for a mid humorus fx?

A

Distal Pulses: Brisk 2+ bilateral, Capillary refill 2 seconds

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17
Q

How can you treat mid humorus fx?

A

Most are non-surgical: Brace (need early mobility to prevent adhesion capsulitis
Surgery: > 3 cm shortening, >30 angulation

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18
Q

What should you not see on an xray of the elbow? if you see it you always assume a fracture?

A

Posterior fat pad

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19
Q

What are the ossification centers?

A

CRITOE: capitullem, radial head, internal epicondyle, trochlea, olecrenon, external epicondyle

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20
Q

MOI of a supracondylar Fx?

A

FOOSH with hyperextension (bike) Peds

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21
Q

What is a complication to Supracondylar Fx?

A

Volksman ischemia = blood into compartment leading to ischemia of new blood.

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22
Q

What can a Supracondylar Fx mimic?

A

A posterior elbow fracture

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23
Q

How can you classify a Supracondylar Fx?

A

Garland classification
1- no displacement
2-posterior displacement = fat pad
3- significant displacement = fat pad

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24
Q

Tx for a Supracondylar Fx?

A

garland 1 = non-surgical

garland 3, N, O = surgical

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25
Q

MOI of a Radial head Fx?

A

FOOSH w/ flexed arm (MC) or posterior elbow dislocation

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26
Q

What can a patient not do with a Radial head fracture?

A

supinate or extend hand

27
Q

How can you classify a Radial head Fx?

A

Mason Classification (mason jar, twish the radial head)
1- fx w/ no displacement
2- fx w/ displacement
3-Many fx w/ displacement

28
Q

Is a radial head fracture 1 of 2 occult fracures?

A

Yes, do a AP, Lateral, Oblique xray

29
Q

How can you tx a mason (radial head) fx

A

Non-surgical: type 1 gets a splint for 5-7 days and supination at day 7 OR type 2 gets a splint for 10-14 days and aggressive ROM and mod displacement with ORIF
Surgery = Type 3

30
Q

What structures form a stabilizing ring?

A

radius, ulna, prox and distal radioulnar joint. single bone fx w/o radioulnar distruption = stable fx

31
Q

MOI of forearm fracture?

A

High impact, MVA, high fall

32
Q

What is a night stick fracture?

A 
Mid ulna (protect yourself from a cop)
TX: brace, non-surgical
33
Q

What is an unstable ulnar fx?

A

Both radius and ulna fx, Monteggia fx (mid to proximal ulna w/ radial dislocation), Galiazza fx (mid to distal radius w/ carpoulnar dislocation)

34
Q

MOI of a distal radial fx?

A

FOOSH with wrist extension = collies (dinner fork)

FOOSH w/ wrist flexion = smith (garden spade)

35
Q

what is the major nerve at risk with a distal radial fx?

A

Median nerve damage

36
Q

what can you do to see if a patient has a colles fx without imaging?

A

ask the patient to push their palm on your hand

37
Q

How can you tx a distal radial fx?

A

Non-surgical: short cast - no displacement, long cast w/ displacement
Surgical: N, O, intra-articular extension, severe comminuted, cant maintain reduction

38
Q

MOI of pediatric distal radial fx?

A

MC <10 yo distal metaphysis, compressed cortex FOOSH

39
Q

Clinical presentation of a peds distal radial fx (buckle)

A

No visible deformation, swelling, guarding

40
Q

Tx for a buckle fracture?

A

short arm cast 4-6 weeks

41
Q

MOI of a green stick fx?

A

Compression and bending FOOSH

42
Q

Clincial presentation?

A

Visible deformity

43
Q

Tx for a green stick fx?

A

Rarely needs surgery, cast for 6-8 weeks

44
Q

Scaphoid fracture MIO?

A

Most common carpal bone fx, FOOSH

45
Q

Scaphoid fracture clinical presentation?

A

snuff box pain, limited ROM

46
Q

Is a scaphoid fx the 2/2 occult fx?

A

yes

47
Q

What is the major complication with a scaphoid fx?

A

Nonunion and osteonecrosis

48
Q

What images do you roder for a scaphoid fx?

A

PA lateral and Scaphoid

49
Q

what is the scaphoid tx?

A

Long are cast with thumb spica for 6-12 weeks and repeat xray 10-14 days

50
Q

if both xrays for a scaphoid fx are negative, what do you do next?

A

MRI, or bone graft from radius

51
Q

What does a traverse or oblique fracture of the metacarpals or phalanges result in?

A

Angulation. A spiral fx = rotation

52
Q

do you do an ortho consult with a fracture of the metacarpals or phalanges?

A

yes, if the displacement is > 2 mm, spiral, communited, or intra-articulation fx

53
Q

What is malrotation?

A

patient makes a fist but his fingers dont all point to his scaphoid.

54
Q

How is the MOI of a boxer’s fracture?

A

punching a wall (men 20s)

55
Q

presentation with boxer’s fist

A

swelling, malrotation, deformity, drop knuckle

56
Q

What is the hand contusion quandary and when would you do it?

A

have the patient push on yout hand with their palm to elicit pain

57
Q

Boxer fracture tx?

A 
Non-surgical = Ulnar gutter splint
surgical =  >15 degrees of angulation, spiral, angulation
58
Q

What is mallet finger and what is its MOI

A

extensor avulation, direct blow to the distal pit of finger = tendon rupture or laceration. Patient cant extend distal tip

59
Q

mallet finger tx?

A

Continous splint 6-8 wk - clock starts again if you extension is lost
Surgical: uses K wire, failure to heal, complete tendon rupture, >30% articulation surface

60
Q

What is jersey finger and what is its MOI

A

Forced extension under forced flexion at base of DF. Usually the ring finger (cant flex it)

61
Q

how do you treat the jersey finger?

A

all require surgry. finger splint with hand surgery (best if done within 7-10 days of injury)

62
Q

What is the MOI of a distal phalanx fracture

A

a direct blow (hammer or mallot)

63
Q

What is a complication of the phalanx fracture?

A

subungual hematoma.always assume a fracture.

64
Q

How can you tx the distal phalanx fracture?

A

take xrays first, if no fx then drill to relieve the pressure.

MJ- Disciplines Exam 3 (11 decks)

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