Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Trauma > Miller's Review Trauma > Flashcards

Miller's Review Trauma Flashcards

Ortho trauma review

1
Q

What does citrate in pRBCs cause

A

Hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a massive transfusion protocol?

A

10U in 24 hours or 4U in 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Labs that suggest adequately resuscitated trauma patient

A

Normal vitals or mild tachycardia, lactae <2.5-4.0, pH > 7.25, base deficit <5.5 and base excess >-5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who gets damage control surgery?

A

Unstable patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Injuries that merit delay in definitive pelvis and femur fracture fixation

A

Severe abdominal (>50% risk reduction if delayed >12 hours), brain and chest injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SIRS criteria

A

T >38, HR >90, RR>20 or PaCO2 <32, WBC <4 or >12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is early appropriate care

A

Fixation of unstable spine, pelvis, acetabulum and femur fractures within 36 hours if adequately resuscitated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Post-injury inflammatory response timing in adults vs kids

A

Adults response peaks at 2-5 days post injury and they can develop multi-organ failure 2-10 days post injury. In kids, it can be seen immediately after injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Timing to convert ex-fix in femur and tibia without increased risk of infection

A

3 weeks in femur, 2 weeks in tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Timing for soft tissue coverage in open fractures

A

Should cover within 7 days to limit infection risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Algorithm for treating bone loss in trauma

A

<5cm defect -> Masquelet. >10cm defect -> bone transport. 5-10cm defect, dealer’s choice.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

LEAP study difference in salvage vs amp group

A

Salvage group had more re-admissions, re-operations and complications. Other outcomes were similar and decreased with time between the groups. Ability to return to work and psychosocial status were linked to outcomes with no difference between amp and salvage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metabolic demand increase seen with Syme, BKA and AKA?

A

Syme 15%, BKA 10% (40% if too short or bilateral), AKA 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Compartment pressure measurement thresholds

A

Within 30mmHg of diastolic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nerve at risk in single vs dual incision fasciotomy

A

Single = CPN. Dual = SPN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Differences between single and dual incision fasciotomy

A

No difference in infection, fracture union or need for skin grafting. Regardless of technique, all patients with compartment syndrome are at increased risk for nonunion and infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fasciotomies for thigh compartment syndrome

A

Lateral incision to get anterior and posterior compartments +/- medial incision to get adductor compartment +/- extend into posterior hip approach if gluteal compartment involved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fasciotomies for foot compartment syndrome

A

Dual dorsal incision medial to the 2nd and lateral to the 4th ray to decompress all 9 compartments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fasciotomies for arm compartment syndrome

A

Direct lateral incision for anterior and posterior compartments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fasciotomies for forearm compartment syndrome

A

Volar superficial and deep layers, mobile wad and dorsal compartment + carpal tunnel release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

High vs low velocity GSW

A

High >2000 ft/sec, low <2000 ft/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

GSW operative indications

A

Low velocity if in subarachnoid or joint space, contaminated wound, associated vascular injury or if bullet passed through abdominal cavity. High velocity wounds all get I&D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

OTA strong recommendations for DVT prophylaxis in trauma patients

A

LMWH preferred over other agents, mechanical prophyalxis used, no routine use of IV filter unless documented PE/DVT despite adequate anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pathophysiology of fat emboli syndrome

A

Inflammatory response to embolized fat results in petechial rash, mental status changes and pulmonary infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

PaO2/FiO2 inf ARDS

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How to position a pregnant trauma patient

A

Left side down lateral decubitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Risk factors for elder abuse

A

Dementia, functional disability, disruptive behavior and poverty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Function of sacrospinous and sacrotuberous ligaments

A

Sacrospinous resist ER, sacrotuberous resist vertical translation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

APC 1 vs APC 2

A

> 2.5cm of anterior pubic diastasis, anterior SI joint widening = APC II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the stable fracture fragment?

A

The crescent portion of an LC-II pelvic ring injury is the constant and stable fragment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Associated injury in LC1 and 2 injuries

A

50% have brain injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Associated injury in APC3

A

Shock in 67%, ARDS in 18%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Associated injury in LC3

A

Bowel in 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Associated injury in vertical shear pelvic fractures

A

Shock (63%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What x-ray is used for supra-acetabular pin start point or LC-II screw?

A

Obutrator outlet, adding oblique gives you the start point for your supra-acetabular screw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What x-ray view is used to ensure screws or pins are between the pelvis inner and outer table?

A

Obturator inlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What x-ray view is used to ensure screws or pins are out of the hip joint and sciatic notch?

A

Iliac oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Most common arterial branch bleeder that needs embolization after pelvic fracture in APC injury? LC?

A

Superior gluteal artery. In lateral compression fractures the obturator is most common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Factors that predict mortality in pelvic fractures

A

Transfusion in 1st 24 hours, age >60, open fracture and unstable pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Management of APC2 injuries? APC3?

A

Needs surgery. Anterior fixation only may be sufficient, can also argue to fix posterior. APC3 gets fixed anterior and posterior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Plate size in fixing pubic symphysis diastasis

A

4 or 6 hole plate, never 2 hole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Where do you want to place an S1 SI screw to avoid the L5 nerve root.

A

Posterior and inferior to the iliac cortical density on the lateral x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Corridor usually blocked in sacral dysmorphism

A

S1, usually the S2 corridor is still good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Structure at risk with anterior SI joint plating

A

L5, this is done via iliac fossa approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most common complication associated with posterior sacral plating

A

Wound complication and hardware infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Treatment of LC1 with incomplete buckle sacral fracture

A

Non-op WBAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Treatment of LC1 with complete sacral fracture and unilateral or bilateral rami fractures

A

Some evidence to suggest early perc fixation improves pain and improve mobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Treatment of LC2 fractures

A

Perc LC2 screw to fix unstable ileum fragement to stable crescent +/- SI screws

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Treatment of vertical shear pelvic fractures

A

Anterior and posterior fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Risk of neurologic injury with sacral fractures

A

Zone 1 = 5%, 2 = 28%, 3 = 57%, can be cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Treatment of lumbopelvic dissociation

A

Lumbopelvic fixation with pedicle and screws into ilium or triangular osteosynthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Key procedure to minimize risk of infection in open pelvis fracture

A

Open pelvic injury is often associated with a perforated viscus that requires a diverting colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Most important determinant in patients long term outcome after pelvic fracture

A

Neurologic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

X-ray needed to diagnose anterior and posterior SC dislocation

A

Serendipity view (40 degree cephalic tilt). Anterior = cephalad. Posterior = caudal displacement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Reduction maneuver for anterior SC dislocation

A

General anesthesia, abduction, extension and direct pressure over the medial clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Posterior SC dislocation reduction maneuver

A

General, bump under medial scapula, abduction and extension, manipulate with towel clip. Do not technically need thoracic surgeon on standby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Post reduction management of posterior SC dislocation

A

Sling x 3 weeks, return to sport at 3-4 months. If recurrent instability consider excision and/or medial ligament reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Treatment of delayed posterior SC joint presentation

A

No closed reduction attempts because of retrosternal adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Medical clavicle physeal fracture management

A

Anterior = observation, can remodel. Posterior = reduce, if irreducible and asymptomatic observe, if symptomatic open reduction with thoracic surgery back up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Rate of nonunion in midshaft clavicle fractures

A

15-20%. Number needed to treat to prevent 1 nonunion is 7.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Re-operation rate after clavicle ORIF

A

18-38% re-operation rate for hardware removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Anterior vs superior clavicle plating

A

Equal healing rates, less symptomatic hardware and fewer re-operations with anterior plating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Distal clavicle fractures at highest risk for nonunion?

A

II and IV (medial to CC ligaments)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Management of distal 1/3 clavicle fractures

A

Non-op in elderly and stable fractures. In unstable fractures, the union rate is higher with surgery, functional outcomes are the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Operative indications for coracoid/acromion fractures

A

1cm displacement

66
Q

Operative indications for intra-articular glenoid fractures

A

2-5mm displacement or instability

67
Q

Operative indications for scapular body fractures

A

Glenopolar angle <20 (normal 30-45), body angulation >45 or medialization of the glenoid >2cm

68
Q

Judet approach interval

A

Infraspinatus (SSN) and teres minor (axillary nerve)

69
Q

Indications for surgical management in double disruption of the superior suspensory shoulder complex?

A

Double disruption in and of itself is not an indication. Treat each isolated injury as you would for its isolated operative indications

70
Q

Most common vascular injury seen in scapulothoracic dissociation

A

Subclavian artery

71
Q

What determines outcomes in management of scapulothoracic dissocation?

A

Neurologic injury, seen in 90%, return of function unlikely, 50% have a flail arm and 21% have an amputation

72
Q

Operative management of engaging reverse Hill-Sachs in posterior shoulder dislocation

A

If 20-40% defect, transpose LT with subscap into defect. If >45% or >6 months out consider arthroplasty or structural allograft.

73
Q

Hertel’s criteria for predicting humeral head ischemia after proximal humerus fracture

A

<8mm metaphyseal extension, disrupted medial hinge, 4 part fracture, >45 degrees angulation, head split

74
Q

Operative indications for 2 part proximal humerus fracture

A

Young person with >50% displacement

75
Q

ORIF vs arthroplasty indications for 3 and 4 part proximal humeral fracture

A

Young person, may consider in active patient <70 with good bone stock and vascularized head. Consider RSA if >70.

76
Q

Where should the greater tuberosity sit in relation to the implant after shoulder hemiarthroplasty?

A

10mm below the implant, 5.6cm proximal to pec insertion

77
Q

Acceptable alignment in humeral shaft fractures

A

20 degrees A/P angulation, 30 degrees varus/valgus angulation, 15 degrees malrotation and 3cm shortening

78
Q

Contraindications to functional bracing humeral shaft fractures

A

Severe soft tissue injury, body habitus, unreliable patient, unable maintain reduction, recumbancy and nerve injury

79
Q

Absolute indications for operative management of humeral shaft fractures

A

Open, vascular injury, floating elbow, intra-articular extension

80
Q

Relative indications for surgical management of humeral shaft fractures

A

Failed close management, polytrauma, associated brachial plexus injury, nerve injury after reduction, pathologic fracture, neuromuscular conditions, delayed/nonunion

81
Q

Preferred approach for proximal 1/3 humeral shaft fractures

A

Anterolateral

82
Q

Preferred approach for maximal humeral shaft visualization

A

Posterior, proximal limit is axillary nerve

83
Q

Nerves at risk for distal interlocks of a humeral nail

A

L->M = radial nerve. A ->P = musculocutaneous nerve.

84
Q

Indication for acute exploration of humeral shaft fracture with radial nerve palsy

A

Open or vascular injury, otherwise observe up to 3-6 months. Consider EMG/NCS at 6 weeks

85
Q

Where do you make the olecranon osteotomy

A

3cm distal to the triceps insertion into the bare area

86
Q

Ligament to release in post-traumatic elbow contractures

A

Posterior band of the MUCL

87
Q

Splinting a post-elbow dislocation when MCL feels intact vs when it feels disrupted

A

If it feels intact, splint in pronation to minimize posterolateral rotary forces. If MUCL and LUCL not intact, splint in neutral because pronation will cause valgus instability.

88
Q

Dorsal Thompson approach interval

A

ECRB and EDC

89
Q

What portions of the pelvis make up the anterior and posterior columns?

A

Anterior column = anterior ilium, wall, dome, iliopectineal eminence and superior ramus. Posterior column = quadrilateral plate, posterior wall, dome, ischial tuberosity and notches

90
Q

What view is this

A

Obturator oblique, shows the anterior column and posterior wall

91
Q

What view is this?

A

Iliac oblique, shows the posterior column and anterior wall

92
Q

5 elementary acetabular fractures

A

Posterior wall, posterior column, anterior wall, anterior column and transverse

93
Q

5 combined type acetabular fractures

A

Posterior column + posterior wall, transverse + posterior wall, t-type, anterior + hemitransveres and both column

94
Q

Type of acetabular fractures with disrupted iliioischial and iliopectineal lines

A

INTACT OBTURATOR: transverse or transverse + posterior wall. DISRUPTED OBTURATOR WITH INTACT ILIAC WING = T-type. DISRUPTED OBTURATOR WITH DISRUPTED ILIAC WING = ant + post hemitransverse or both column fracture (spur sign, shown)

95
Q

What is the stable fragment in an associated both column acetabular fracture?

A

The proximal ilium, the whole articular segment is medialized

96
Q

What is this sign?

A

Gull sign indicating superomedial acetabular dome impaction. It is associated with quadrilateral plate displacement and is a very poor prognostic sign.

97
Q

Non-operative indications for acetabular fractures

A

Displacement <2mm, intact weight bearing dome (roof arc >45 degrees, shown), posterior wall <20% (stable on fluoro exam under anesthesia)

98
Q

Fluoro stress exam for posterior wall acetabulum fractures

A

General, flex hip to 90 deg w/neutral rotation, apply axial load and see if it subluxates on the obturator oblique view

99
Q

Acetabular fracture with worst prognosis

A

T-type, requires more extensive and/or combined approaches to obtain reduction

100
Q

Indications for ORIF + acute THA in acetabular fractures

A

Osteoporotic and/or significant comminution in elderly patients.

101
Q

Surgical approach for most anterior acetabular fractures

A

Modified Stoppa. Extraperitoneal intrapelvic approach through the rectus abdominis. Look out for corona mortis 5cm lateral to symphysis

102
Q

Approach for T-type acetabular fractures

A

Kocher-Langenbeck for posterior, Stoppa for anterior

103
Q

Most common complications seen in acetabular fractures

A

Post-traumatic arthrosis, HO (greatest in extended iliofemoral and KL approaches, debride minimus if traumatized), DVT/PE, iatrogenic nerve injury (sciatic, femoral)

104
Q

What determines clinical outcomes after acetabular fractures?

A

Good outcomes correlated with anatomic articular reduction, surgery <10-14 days, no femoral head chondral injury, no comminution, no acetabular impaction, age <55

105
Q

Indication for extensile approach to acetabulum

A

Both column and anterior + posterior hemitransverse

106
Q

Why should a patient with a posterior hip dislocation be a full trauma activation?

A

They are associated with traumatic rupture of thoracic aorta

107
Q

Most common complication seen after post traumatic hip dislocation

A

Post-traumatic arthritis > AVN

108
Q

Operative algorithm for femoral head fractures

A

Pipkin I (below fovea) and II (above fovea) typically have an anterior and inferior fracture fragment that can be approached anteriorly, no risk for AVN here. Pipkin III: fix neck and head from front. For Pipkin IV (femoral head + posterior acetabulum fracture): treat with trans-trochanteric approach to address both the femoral head and acetabulum.

109
Q

Pauwel’s classification

A

As you progress from grade I to III, rates of osteonecrosis and AVN increase

110
Q

In hospital and one year mortality for geriatric femoral neck fractures

A

In hospital 6%, 1 year 22%

111
Q

Operative management of basicervical femoral neck fracture compared to more proximal femoral neck fractures

A

FAITH trial showed better outcomes with DHS compared to cannulated screw fixation in basicervical fractures only. Screws also did worse than DHS in smokers.

112
Q

Most common complication of displaced femoral neck fractures in young patients

A

AVN > non-union

113
Q

Normal timed up and go test

A

If patient can get up walk 10 feet and sit down within 12 seconds they will likley not need an ambulatory device.

114
Q

FRAX score

A

10 year probability of fragility fracture calculator based on clinical factors and bone mineral density

115
Q

Surgical management of femoral head varus nonunion/malunion after fracture in young patient with no AVN

A

Valgus intertrochanteric osteotomy

116
Q

Most important indicator in determining stable vs unstable intertrochanteric femur fracture

A

Integrity of the lateral wall

117
Q

AAOS hip fractures strong recommendations

A

General vs spinal = equivalent outcomes. Arthroplasty if displaced femoral neck. CMN for instable intertroch and subtroch. Standard transfusion thresholds. Intensive post-discharge PT. Interdisciplinary care and multi-modal pain control.

118
Q

Timing of fixation of femoral shaft fractures

A

Decreased pulmonary complications, decreased VTE, faster rehab, lower hospital costs if fixed within 24 hours. Contra-indicated in severe closed head injury.

119
Q

When to consider unreamed femoral nail?

A

Bilateral fractures or blunt chest trauma have increased risk of pulmonary complications and mortatility, consider not reaming in bilateral injuries or those with blunt chest injury. Otherwise always ream because the union rate has been shown to be higher if reamed.

120
Q

Location of proximal interlocks for retrograde IMN

A

At or above the level of the lesser trochanter to avoid stress riser and vascular injury if more distal

121
Q

Indications for retrograde IMN for femoral shaft fracture

A

Distal 1/3, obese, floating knee, bilateral femur fractures, ipsilateral neck-shaft fracture, ipsilateral acetabular fracture.

122
Q

Malunion seen after fixing femoral shaft fractures by table/positioning?

A

Supine = IR. Lateral = ER. Traction = too long. No traction = too short.

123
Q

Malunion seen after fixing femoral shaft fractures by location?

A

Proximal shaft = IR. Distal shaft = ER.

124
Q

Rotational deformity best tolerated in malrotated femoral shaft fractures

A

IR

125
Q

Degrees of malrotation tolerated in femoral shaft fractures

A

<15

126
Q

Compared to patients with unilateral femur fractures, patients with bilateral fractures are at increased risk of ___

A

Death

127
Q

Which condyle is most commonly seen in the Hoffa fracture?

A

Lateral

128
Q

Most common direction of knee dislocation

A

Anterior

129
Q

Timing for limb revascularization

A

Within 8 hours

130
Q

Tibial plateau operative indications

A

Articular depression <3mm, condylar widening <5mm, all bicondylar and medial plateau fractures.

131
Q

Injury to beware of when using >10 hole lateral tibial plateau plate

A

SPN

132
Q

Most important treatment variables in determining outcomes in tibial plateau fractures

A

Restoration of joint stability and mechanical axis. Patients >50 have worse outcomes. Higher risk of TKA with low surgeon and hospital volume.

133
Q

Acceptable parameters in tibial shaft fractures

A

Varus-valgus <5, sagittal plane <10, cortical apposition >50%, shortening <1cm, rotation alignment within 10 degrees

134
Q

Malunion seen in proximal 1/3 tibial shaft fractures

A

Valgus and procurvatum

135
Q

Ex-fix vs IMN in open tibial shaft fractures

A

No difference in infection or time to union. IMN w/better alignment, fewer secondary surgeries and shorter time to WB

136
Q

Reamed vs unreamed IMN in open fractures

A

No difference in results in reamed vs unreamed for open fractures. Reamed nailing was superior in closed fractures (fewer dynamizations, fewer implant failures)

137
Q

Relative indications for early amputation in open tibia fractures

A

Warm ischemia >6 hours, severe muscle damage and severe ipsilateral foot trauma

138
Q

Tibial nonunion defined as

A

No healing by 9 months, delaying treatment for 6 months showed fewer reooperations in the SPRINT trial

139
Q

Predictor for tibial nonunion treatment failure after dynamization or exchange nailing

A

Persistent gap >5mm

140
Q

Technique for exchange nailing in tibial nonuion

A

Ream/upsize nail, dynamically lock and fibular osteotomy

141
Q

BMP-2 approved for? BMP-7?

A

BMP-2 in open tibia fractures. BMP-7 in long bone nonunions.

142
Q

Most sensitive physical exam finding in compartment syndrome

A

Pain with passive stretch

143
Q

Most sensitive overall indicator of compartment syndrome

A

Delta P<30 (compartment pressure measurement within 30mmHg of DBP)

144
Q

Highest risk variable for re-operation in tibial shaft fracture

A

Cortical contact <50%

145
Q

Most common type of malalignment after IMN of distal 1/3 tibia fractures

A

Malrotation

146
Q

Most common complication after fixation of tibial plafond fractures

A

Post-traumatic arthrosis

147
Q

Brake time while driving returns to normal at what time point?

A

6 weeks after patient is cleared for full weight bearing

148
Q

Normal talo crural angle

A

80 degrees

149
Q

Hawkins classification for talar neck fractures

A

I) fracture without diplacement II) fracture with displacement at subtalar joint III) fracture with extruded head and reduced TN joint IV) pantalar fracture dislocation

150
Q

Primary blood supply to talar body

A

Artery of tarsal canal from posterior tibial artery

151
Q

Approach for talar neck fractures

A

Dual insicions to address dorsomedial comminution

152
Q

Operative management of varus malunion of talar neck fractures

A

Medial opening wedge osteotomy

153
Q

Interposing structures blocking reduction of medial vs. lateral subtalar dislocations

A

Medial = fractured talar head fragement, EDB. Lateral = post tibial tendon, FHL

154
Q

Normal Bohler’s angle

A

20-40 degrees, flattening = collapse of posterior facet

155
Q

Normal angle of Gissane

A

130-145, increased = posterior facet collapse

156
Q

Sanders classification

A

Based on number of fracture lines seen in the posterior facet

157
Q

Constant fragement in calcaneus fractures?

A

Sustentacular fragment

158
Q

Primary fracture line orientation in calc fractures

A

Anterolateral to posteromedial

159
Q

Treatment of choice for Sanders IV fractures

A

Can consider ORIF vs primary arthrodesis

160
Q

Factors predicting poor outcome in calc fractures

A

Smoking, diabetes, age > 50, male, obesity, manual laborer and worker’s comp

161
Q

Surgical management of calc fracture malunion

A

Distraction bone block subtalar arthrodesis to restor calc height

Trauma (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions