MSK Trauma Flashcards
Non displaced fracture
In anatomical position
commented fracture
More than 2 pieces
osteotomy
surgery where part of the bone must be removed
Iatrogenic
when bone is fractured unintentionally during a surgery
Stages for fracture healing
Hematoma
soft callus
hard callus
remodeling
Goals of fracture treatment
obtain reduction
maintain reduction
obtain union
rehabilitation
What fractures do need surgery
open fractures
most displaced femoral fractures
most displaced forearm fractures
all irreducible dislocation and fracture dislocations
Acromioclavicular Joint Dislocation
Mechanism
- Falls
- Direct trauma
Diagnosis
-PE
- Xray
Treatment
- Sling
- Surgical repair
Clavicle
•Mechanism
–Indirect
–Direct
- Diagnosis
- Treatment
–Min displacement
-sling
–Displaced - ORIF
Humerus
•Mechanism
–Direct blow
–Indirect
–GSW
•Types
–Displaced
–Non-displaced
deltoid and pectoralis major may contribute to displacement
Distal Radius
- Common upper extremity fracture
- Min displaced – closed treatment
Forearm
- Mechanism: falls, direct blow, GSW
- Single bone, min displaced – closed treatment
Hip Dislocation
- Major trauma•Mechanism–Falls–MVA
- Treatment – immediated closed reduction
- Complication - AVN
- Age group: Elderly•Risk factor: osteoporosis
- Mechanism: falls
- Treatment: Surgical
- Complications–Loss of fixation–AVN
Intertrochanteric Fracture
- Age group: Elderly
- Risk factor: osteoporosis
- Mechanism: falls
- Treatment: Surgical
- Complications–Loss of fixation–Leg length inequality
Knee dislocation
- Mechanism: MVA, sports, falls
- Treatment–Early: immediate reduction–Definitive: ligament reconstruction
- Complications: neurovascular injury
Knee Anatomy
- 4 ligament structures- •ACL•PCL•MCL
- LCL & PLC (lateral side)•Popliteus•Biceps femoris•Popliteofibular lig.•ITB•Capsule•
Patella tendon
Tibia Fracture
- Mechanism: direct, indirect
- Min displaced – closed treatment
- Displaced - surgery
Ankle
- Common lower extremity fracture
- Mechanism: torsion•Non-displaced – immmobilization
- Displaced - surgery
Lateral Collateral Ligaments
- Anterior Talofibular Ligament–First injured in lateral sprain with plantarflexed ankle (most common)
- Calcaneofibular Ligament–Strongest lateral ligament–First injured in lateral sprain with dorsiflexed ankle
- Posterior Talofibular Ligament
Medial collateral ligaments
•Superficial–Superficial talotibial, naviculotibial, and calcaneotibial fibers–•Deep–Deep anterior talotibial and posterior talotibial fibers from posterior colliculus to talus–Strongest portion of the Deltoid ligament
Pelvis fractures
- Major trauma•Potentially life-threatening – hemorrhage
- Treament–External fixation–ORIF
Cervical spine
- Potentially life threatening•Life altering
- Early and accurate diagnosis critical
- Spinal cord injury common
- Treament principles–Stability–Preservation of function
- Treatment– collar–Halo–Surgery
Dislocation
traction to acheive reduction
definite treatment: arthrodesis
Thoracolumbar spine injuries
- Mechanism–Falls–MVA
- Often assoc with multiple trauma
- Spinal cord injury common
Burst fracture
Pediatric distal radius
- Common injury
- Mechanism: fall on outstretched hand
- Usually treated with closed reduction and casting
Pediatric forearm
- Mechanism: falls
- Treament–Closed reduction–Flexible nails in older children
- Complication: loss of forearm rotation
Pediatric growth plate fractures
- Usually treated closed
- Accurate reduction is goal
- Complication: growth disturbance
Growth arrest
- Uncommon
- Results from injury to physis
- Treatment–Excision of bar–Osteotomy to correct deformity
Pediatric femur fractures
- Common injury
- Must exclude child abuse
- Usually treated in spica cast in young children
- Flexible nails in older children
Ped. distal femoral physeal fracture
- Mechanism: falls, MVA
- Treatment: reduction and pinning
- Complication: growth disturbance
Mechanism of distal femoral physical fracture
•Mechanism: falls, direct or indirect trauma•Treatment–Reduction and casting–Flexible nails in older children
