MSK Injuries Flashcards
Name the fx’s L to R
- Oblique
- Comminuted
- Spiral
- Compound
Name the fx’s L to R
- Greenstick
- Spiral
- Comminuted
- Transverse
- Compound
What type of fx?
Greenstick
What type of fx?
Spiral
What type of fx?
Compound
What type of fx?
Comminuted
PE findings on fx’s?
pain
edema
deformity
crepitation
abnormal motion
What should be assessed before and after application of a cast or splint?
Neurovascular status
When should I get an x-ray?
any tender/deformed area over bone; include joints above and below
Long bone fx’s may be associated with what?
Splinting is considered what?
Goal is what?
significant blood loss
essential
realign extremity in as close proximity as possible to reduce motion & ultimately blood loss, pain, further soft tissue injury
Open fx’s may be associated with what?
significant muscle damage
contamination
Fx Management
Resuscitate
Apply direct pressure over visible bleeding source
sterile pressure dressing if open fx
Prompt surgical c/s
Pain control
Abx coverage for open fx grades I & II includes what?
For how long?
GP coverage
preop coverage & DC 24 hrs after wound closure
Abx coverage for grade III open fx includes what?
for how long?
GP + GN
preop coverage & cont x 72hrs after time of injury or no > 24 hr after closure whichever occurs 1st
Abx coverage for fecal or potential clostridial contamination includes?
High-dose PCN
Pelvic Fx
Most common type?
MOI?
Injury usually doesn’t destroy what? maintains what?
Associated injuries?
Lateral Compression fx
MVC; Pedestrian struck from side
ligamentous integrity; pelvic stability
visceral abdominal injuries; thoracic content injuries, C-Spine injury
Pelvic Fx: AP Force Injury
Mechanism?
Injury often includes what?
Vascular damage to what?
Motorcycle accident: w/ lower extremities acutely spread apart; Pedestrian struck/crushed by MV
Lumbosacral plexus injury
Internal iliac artery & accompanying veins in close proximity to posterior SI ligaments(possible injury to common or external illiac)
Pelvic Fx: Vertical Shear Injury
Mechanism?
Injury disrupts what?
Complications?
Higher rate of what?
Jump from height & land on extended LE
all restraining ligaments of hemipelvis (sympheseal, sacrospinous, sacrotuberous, & SI)….hemipelvis unstable
Shock, retroperitoneal hematoma, vascular injury
abdominal injury
Pelvic Fx S/Sx?
Progressive flank, scrotal, perianal edema & ecchymosis
Instability: leg-length discrepancy, rotational deformity
Acetabular Fx Classification based on what?
Anterior column?
Posterior column?
Column involved
anterior iliac crest, anterior 1/2 of acetabulum, & pubic ramus
sciatic buttress & sciatic notch, posterior 1/2 of acetabulum, ischial tuberosity
Acetabular fx: Imaging includes?
Judet x-rays: Iliac oblique, obturator oblique
Acetabular Fx Treatment
to achieve spherical congruency
any incongruence in weight bearing surface must be treated surgically
Acetabular Fx complications inlcude?
Post-traumatic degenerative joint disease
femoral head osteonecrosis
Heterotrophic ossification
DVT
Osteoarthritis
Crush injuries include
bleeding
bruising
compartment syndrome
fracture
laceration
Cellular response to crush injury includes
Which pump malfunctions?
Increased permeability causes IC contents to leak into serum, what are those?
EC compartment contents go to injury site, what are those? and what is the result?
These shifts can occur for how long after injury?
If left untreated what can occur?
Na/K pump
K+, uric acid, PO4, Cr & CK
H2O, Na+, Ca++, & Cl –> hypovolemia from sequestration & shock
days after injury
rhabdomyolysis & AKI
Crush injury complications
Compartment syndrome
High intra-compartmental pressures mediate what?
Compartment pressures > 30mmHg inhibit what?
further ischemia, damage & necrosis
Perfusion & muscle & nerve damage
