MS 1

Question 1

closed fracture - can be what two things

Answer 1

complete or incomplete

Question 2

closed fracture - complete meaning

Answer 2

all the way through the bone

Question 3

closed fracture - complete types
4

Answer 3

1. transverse - runs perpendicular to the long axis of the bone
2. oblique - runs diagonally to the long axis of the bone
3. spiral - corkscrew shaped fx resulting from rotational/torsional force
4. communited - >2 fracture fragments

Question 4

closed fracture - incomplete meaning

Answer 4

the entire cortex is not broken - more common in peds

Question 5

fracture - incomplete types
3

Answer 5

1. bowing - bending
2. toru/buckling - bulging of the cortex
3. greenstick - cortex fx on one side of the bone

Question 6

fracture types
2

Answer 6

closed
open

Question 7

open fracture

Answer 7

fracture w/ direct communication to the external environment

Question 8

sprains

Answer 8

overstretching or tearing of ligaments

Question 9

overstretching or tearing of ligaments

Answer 9

sprain

Question 10

grade 1 sprain (mild)

Answer 10

slight stretching and some damage to ligament fibers

Question 11

grade 2 sprain (moderate)

Answer 11

partial tearing of ligaments w/ joint laxity

Question 12

grade 3 sprain (severe)

Answer 12

complete tear of the ligament w/ instability

Question 13

disolcation

Answer 13

abnormal separation in the joint

Question 14

types of dislocations
2

Answer 14

1. luxation - complete dislocation
2. subluxation - partial dislocation

Question 15

abnormal separation in the joint

Answer 15

dislocation

Question 16

complete dislocation of joint

Answer 16

luxation

Question 17

partial dislocation of joint

Answer 17

subluxation

Question 18

overstretching or tearing of ligaments

Answer 18

sprain

Question 19

fracture/sprain/dislocation - patient may present with what signs and symptoms of the affected joint
3

Answer 19

pain, swelling. ecchymosis of affected joint

Question 20

fracture/sprain/dislocation - physical exam
3 (perform, perform, assess)

Answer 20

1. perform comprehensive evaluation of tendon function w/ ligament stability
2. perform motor and sensory exam
3. assess pulses

Question 21

fracture/sprain/dislocation - img/testing
1

Answer 21

x rays

Question 22

Ottowa ankle rules
4

Answer 22

1. ankle x ray if any pain along the malleolar region AND any of the following
2. bony tenderness along distal 6 cm of posterior edge of tibia or fibula
3. bony tenderness at tip of medial or lateral malleolus
4. inability to bear weight immediately or after 4 steps during exam

Question 23

foot x ray if
4

Answer 23

1. any pain in the midfoot region AND any of the following
2. bony tenderness at the base of the 5th metatarsal
3. bony tenderness at the navicular
4. inability to bear weight immediately or after 4 steps during eval

Question 24

Ottowa knee rules - if any of the criteria are met, consider knee x ray
5

Answer 24

1. age >55
2. isolated tenderness of the patella
3. tenderness at the fibular head
4. unable to flex knee 90 degrees
5. unable to bear weight both during eval and immediately after injury

Question 25

fractures/sprains/dislocations - tx (in general) 4

Answer 25

1. acetaminophen 2. NSAIDs 3. ice 4. splints

Question 26

splinting tips 3

Answer 26

1. splint above and below site of injury 2. ensure adequate padding, especially over fracture site 3. assess neuro status after splinting

Question 27

open distal phalanx fx aka "tuft" fx tx most can be managed where

Answer 27

most can be managed in UC

Question 28

all other open fx except open distal phalanx tx

Answer 28

refer to ER

Question 29

when to refer to ortho 3

Answer 29

1. high grade sprain 2. stable fractures 3. suspected fx not seen on imaging i.e. Salter-Harris

Question 30

sprains f/u with who

Answer 30

w/ PCP

Question 31

MSK - when to refer to ER 5

Answer 31

1. open fracture 2. concern for compartment syndrome 3. neurovascular compromise 4. dislocations that cannot be reduced 5. inability to bear weight w/ no obvious fracture - suspected hip or pelvic injury