MSK procedures

Question 1

S/S of fx

Answer 1

Pain
Swelling 
Deformity 
Eccymosis 
LOF

Question 2

what is the most reliable sign of a fx?

Answer 2

PAIN

Question 3

Open fx

Answer 3

a fracture that has communicated with the outside environment.
Regardless of size

Question 4

Salter Harris classification

Answer 4

fx in child,
evaluate integrity of growth plate
higher number is worse px

Question 5

SH I

Answer 5

S=Slipped
slip of growth plate
Transverse fx thru growth plate

slight widening of the plate at either side

Question 6

SH II

Answer 6

ABOVE
fx thru Metaphysis only
MCC (70%)

Question 7

SH III

Answer 7

LOWER

fx just thru epiphysis and growth plate

Question 8

SH IV

Answer 8

THROUGH

fx thru epihysis and metaphysis and thru the growth plate

Question 9

SH V

Answer 9

compression of growth plate (or ate least part of it)
“rammed and ruined”
worst possible outcome
1% of all fx

Question 10

Colles Fracture

Answer 10

fx of distal radius
may involve the ulnar styloid
caused by falling on outstretched hand
dinner fork deformity

Question 11

Trimalleolar fx

Answer 11

fx of the lateral malleolus
medial mallolus and the posterior tibia

landing flat on the heal form a height 
very unstable (ORIF)

Question 12

Compartment Syndrome

Answer 12

complication of fx

The pressure inside the facial compartment exceeds the blood pressure.
Causes compromise of the circulation to the soft tissue, ischemia and necrosis.
Irreversible damage can occur in 8 hours.
tx w/ fasciotomy

Question 13

systemic complications of fx

Answer 13

Fat embolism (think long bone or pelvic fx) 
or throboembolism

Question 14

myositis ossificans

Answer 14

calficiations and bony masses can form in muscle

especially if there was a lot of bleeding

Question 15

algodystrophy

Answer 15

regional pain syndrome

CHRONIC PAIN IN AREA OF FX

Question 16

fracture blisters

Answer 16

vesicles or bullae arise in swollen skin directly over a fx

24-48h post injury
fluid or blood filled
can increase infection rate

Question 17

Grade III Sprain

Answer 17

may need to immobilize
Severe pain–>NO PAIN
Diffuse swelling
Complete laxity of ligaments (lateral)

Question 18

how long does it take for fx to heal

Answer 18

6-8 weeks

think delayed union

Question 19

Grade I sprain

Answer 19

mild pain, little swelling, joint stiffness w/o laxity

ATF- brace

Question 20

Grade II sprin

Answer 20

partial tear of lateral ligaments

moderate pain w/ loss of function

Question 21

long vs short arm cast

Answer 21

Long arm cast PREVENTS supination and pronation

if fx is in the shaft… you need to do the long arm
short arm is OK for Colle’s