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SRGRY3 > ORTH SCP > Flashcards

ORTH SCP Flashcards

1
Q

Top 3 injuries associated with scapula fracture

A

injury of
head
ribs
lungs

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2
Q

pulmonary injuries occur in how much of patients with scapulrar fracture

A

1/3

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3
Q

most scapular fracture is treated with

A

sling

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4
Q

surgery for scapular fracture is indicated when

A

there is involvement of glenoid with a major particular step off or if there is a glenoid rim fracture or subluxation of the joint

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5
Q

most commobly dislocated large joint

A

shoulder specifically glenohumeral joint

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6
Q

most dislocations of the glenohumeral joint are

a. anterior
b. posterior
c. lateral
d. medial

A

A

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7
Q

injuries(avulsion) of the anterior inferior glenoid laBrum is called

A

Bankart lesion

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8
Q

impaction fractures of the Humeral Head

A

Hill-Sachs lesion

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9
Q

3 lesions associated with shoulder dislocations

A

Bankart lesion
Hill Sachs
Rotator cuff

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10
Q

nerve most at risk with shoulder dislocations

A

axillary nerve

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11
Q

if elderly patient with shoulder dislocation is unable to raise the arm after reduction of shoulder, the reason is probably

A

rotator cuff tear

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12
Q

if young patient with shoulder dislocation is unable to raise the arm after reduction of shoulder, the reason is probably

A

axillary nerve injury

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13
Q

dislocation rate of shoulder dislocations if the patient is younger than 20 years

A

90%

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14
Q

these type of shoulder dislocations are associated with seizure or electric shock

A

Posterior dislocations

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15
Q

what is the most important plain radiography view for shoulder dislocations

A

axillary view

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16
Q

what should be done for a patien lt with shoulder dislocation when axillary view cannot be obtained?

A

computed tomography

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17
Q

treatment of shoulder dislocations

A

closed reduction followed by a short period of sling immobilization

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18
Q

historical system of classification of proximal humeral fractures

A

Neer’s classification

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19
Q

4 parts of the humerus according to Neer’s classification

A

He let go of her

humeral head
greater tuberosities
lesser tuberosities
humeral shaft

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20
Q

3 factors that determine treatment of proximal humeral fracture

A

displacement of the fracture fragments
amount of angulation of the fracture
amount of comminution

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21
Q

indication of ct scan in humeral fracture

A

suspicion of intra articular fracture

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22
Q

tx of majority of proximal humerus fractures

A

sling immobilization
early shoulder motion
pendulum exercises

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23
Q

How long after proximal humers fracture should physiotherapy be done to prevent stiffness? (esp in the elderly)

A

2 weeks

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24
Q

what is the treatment of choice for proximal humerus fracture if therr is adequate bone stock and fracture can be successfully reduced

A

Open reduction internal fixation with plate and screw fixation

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25
Q

older patients w/osteoporosis, comminuted fractures, head-splitting fractures and 4-part fracturrs or fracture dislocations are typically treated with

A

prosthetic replacemenr of the humeral head or hemiarthroplasty

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26
Q

True about humeral shaft fractures

a. majority of humeral shaft fracturrs can heal with nonsurgucal mgt
b. radial nerve spirals around the humeral shaft and at risk of injury
c. radial nerve palsy is manifeste as wrist drop
d. most radial nerve injuries are neuropraxias

A

AOTA

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27
Q

most radial nerve injuries after humeral shaft fractures are neuropraxias and function will return within

A

3-4 mos

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28
Q

A spiral fracture of the distal one third of the humeral shaft is commonly associated with neuropraxia of the radial nerve and this is called

A

Holstein Lewis Fracture

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29
Q

Criteria for acceptable alignment of Humeral.shaft fractures

A

less than 20deg anterior angulation
less than 30deg varus/valgus angulation
leas than 3cm shortening

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30
Q

T/F radial nerve palsy is a contraindication to conservative treatment

A

F. not a contraindication

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31
Q

Neer’s classification: Surgical Neck

A

III

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32
Q

Neer’s classification: Greater tuberosity

A

IV

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33
Q

Neer’s classification: Anatomical Neck

A

I

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34
Q

Neer’s classification: Lesser tuberosity

A

V

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35
Q

Neer’s classification: Minimal Displacement

A

I

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36
Q

Neer Classification humeral head fracture

No fragments meet the criteria for displacement ( any fracture pattern less than 1cm displacement)

A

1 part

37
Q

Neer classification: one tuberosity is displaced and the surgical neck fracture is displaced, the remaining tuberosity is attached which produces rotational deformity (at least 1cm displacement)

A

three part

38
Q

Neer classification

one segment is displaced which may be the greater tuberosity, lesser tuberosity, or articular segment at the level of anatomic neck or surgical neck

A

two part

39
Q

Neer classification

both tuberosities, articular surface and shaft meet the criteria for displacement

A

four part

40
Q

diagnostic done to monitor recovery of radial nerve after humeral shaft fracture and ORIF

A

EMG

41
Q

mechanism of fractures of the distal humerus

A

fall onto the elbow or onto outstretched arm

42
Q

What’s the most common fracture of the distal humerus?

A

Supracondylar fractures

43
Q

minimally displaced distal humerus fractures can be treated with

A

posterior long arm splint wirh the elbow typically flexed to 90deg

44
Q

severely comminuted distal humerus fractures can be treated with

A

elbow replacement

45
Q

common mechanism of elbow dislocations

A

typically occur with fall on outstretched hand

46
Q

Terrible triad of elbow dislocations

A
  1. injury to the joint capsule and rupture of the lateral collateral ligament/ possible involvement of the medial collateral ligament
  2. possible fractures of the radial head and 3.coronoid

REC
radil head elbow coronoid

47
Q

recommendations to avoid stiffness of the elbow for simple elbow dislocations

A

short term immobilization of about 7-10 days follwed by early range of motion

48
Q

characterized by a fracture of the radial head, dislocation of the distal radioulnar joint and rupture of the antebrachial interosseous membran

A

Essex-Lopresti fracture

49
Q

surgery is recommended for radial fractures when (4)

A 
D DBW
displaced fracture
dislocation of the elbow
blocks supination or pronation
wrist pain
50
Q

radial head comminuted fracture management of choice

A

radial head replacement with metallic head implant

51
Q

mechanism of olecranon fractures

A

fall on flexed elbow

52
Q

tx of olecranon fractures, nondisplaced,

A

splint 45-90deg of flexion

53
Q

muscle that inserts into the olecranon

A

triceps

54
Q

tx of olecranon fracture

A

surgical fixation

55
Q

common mechanism of forearm fractures

A

fall on outstretched arm

56
Q

what is a nightstick fracture

A

isolatrd fracture of the ulna shaft

57
Q

mechanism of nightstick fracture

A

direct blow to the side of the forearm

58
Q

fracture of the proximal third of the ulna associated with radial head dislocation

A

Monteggia fracture

59
Q

fracture of distal third radial shaft associated wirh distal radioulnar joint injury at the wrist

A

Galeazzi fracture

60
Q

distal radius fracture causing dorsal displacement of the distal radius. Presents as dinner fork deformity

A

Colles fracture

61
Q

distal radius fracture causing volar displacement of the distal radius. a.k.a reverse colles smith

A

Smith’s fracture

62
Q

areintra-articular fracturesof theradial styloidprocess. The radial styloid is within the fracture fragment, although the fragment can vary markedly in size.

A

Chauffer’s fracture
Hutchinson fracture
Backfire fracture

63
Q

Intr articular volar or dorsal fracture with associated dorsal subluxation/dislocation of the radiocarpal joint.

A

Barton’s fracture

64
Q

the ff are true with forearm fractures

a. every attempt should be made to rule out feactures that extend intra articularly into the wrist joint or involve the DRUJ
b. Osteoporosis should be ruled out
c. median nerve injury is possible
d. loss of thumb extension from extensor pollicis longus tendon rupture can occur especially in nondisplaced distal radiua fractures

A

AOTA

65
Q

usual tx for forearm fractures

A

closed reduction

66
Q

WHAT IS THE MOST COMMON FRACTURE OF THE CARPAL BONE

A

scaphoid

67
Q

sequelae of missed scaphoid fracture

A

nonunion and avascular necrosis

68
Q

most common site of scaphoid fracture and higher incidence of avascular necrosis

A

proximal

69
Q

this clinical.finding suggesrs scaphoid fracture and should be considered as such until proven otherwise

A

pain in the anatomical snuff box

70
Q

the ff diagnostic test is helpful if no fracture is seen on xray

a. MRI
b. CT scan
c. Utz

A

A

71
Q

true about pelvic fractures EXCEPT

a. pelvic fractures are indicative of high energy trauma
b. hemorrhage from pelvic trauma can be life threatening
c. hemodynamic instability would require immediate open reduction and internal fixation
d. ratio of blood ffp and platelets to be given in hemodynamically unstable px is 1:1:1

A

C. resucitation with fluids and blood

72
Q

Describe an open book.mechanism of pelvic injury

A

anteroposterior compression mechanism. pelvis springs open, hinged on the intact posterior ligaments with widening of the pubic symphysis

73
Q

initial.management for open book fracture of the pelvis

A

pelvic binder

74
Q

fractures of the sacrum may be difficult to see on xray. what could be done to visualize ?

A

CT scan

75
Q

compression of the nerve roots below the level of the spinal cord causing paralysis, impaired bladder and/or bowel control, loss of sexual sensation, and other problems. Even with immediate treatment, some patient may not recover complete function.

A

cauda equina syndrome

76
Q

indications for anterior plate and posterior fixation for pelvic fracture

A

pubic symphysis is widened 2.5 cm

posterior pelvic ligaments are also injured

77
Q

function of this nerve should be examined after acetabular fracture

A

sciatic nerve

78
Q

sequelae of hip dislocation not reduced immediately

A

avascular necrosis of femoral head

79
Q

45 degree views used to evaluate acetabular fracture

A

Judet views

80
Q

true about hip dislocations

a. hip dislocations usually result from low impact trauma
b. most commonly occur posteriorly
c. acetabular fracture is rare
d. closed reduction is usually unsuccessful

A

B

a. high energy trauma
c. common
d. usually succwaaful

81
Q

What is a Pipkin fracture

A

femoral head fracture associated with hip dislocation

82
Q

true about hip fractures EXCEPT

a. more common in women
b. more common in of with osteoporosis
c. Three most common fractures in the elderly are those of shoulder, spine and hip
d. patients who suffer from hip fractures are at increased risk of DVT
e. early ambulation diminishes risk for many of these adverse events

A

C. wrist, hip, spine (WHS)

83
Q

what is the treatment of choice for hip fractures

A

surgery within 24-48 hrs

84
Q

goals of surgery for hip fracture

A

minimize pain
restore hip function
allow early mobilization

85
Q

main blood supply for femoral neck

A

deep branches of the medial femoral circumflex arteries

86
Q

true about intertrochanteric hip fractures

a. occur between the greater and lesser trochanter of the distal femur
b. osteonecrosis is common
c. reverse oblique intertrochanteric fracture exits on the medial cortex
d. reverse oblique intertrochanteric fracture is best treated with a cephalomedullary nail
e. dynamic hip screw is the right device to be used in reverse oblique fractures

A

D

a. proximal femur
b. uncommon
c. lateral cortex
e. wrong device

87
Q

true about subtrochanteric hip fractures EXCEPT

a. usually at proximal shaft just distal to the lesser trochanter in an area of high biomechanical stresses
b. tend to be significantly displaced
c. most often treated with long cephalomedullary nail
d. it could to bisphosphonate use

A

AOTA

88
Q

True of femoral shaft fractures EXCEPT

a. associated with risk for complications such as thromboembolic events
b. most commonly fixed with intermedullary nail
c. Trauma patients who are hemodynamically unstable are treated immediately with open reduction
d. NOTA

A

C. initially, they should have external fixation until the time they can undergo surgery. this is called damage control orthopedics

89
Q

coronal fractures thay usually involve the lateral femoral condyle

A

Hoffa fractures

SRGRY3 (44 decks)

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