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Ortho 2 Flashcards

1
Q

What are the two main types of pelvis fractures?

A

Superior/inferior rami

High energy impact

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2
Q

Treatment for pelvic fractures?

A

Conservative:

  • OT/PT
  • May need hospitalization for pain control
  • Weight-bearing as tolerated
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3
Q

What fracture accompanying a pelvic fracture indicates instability?

A

L5 transverse process fracture

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4
Q

What kind of high impact pelvic fracture involves AP compression?

A

Open-book fracture

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5
Q

How much blood do pts. with open book fractures need?

A

6-15 units

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6
Q

What type of high impact pelvic fracture has biggest risk of vascular injury?

A

Vertical shear fracture

-Lateral compression

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7
Q

Most pelvic bleeding is from what source?

A

Venous

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8
Q

Management for a high impact pelvic fracture?

A

-2 large-bore IVs
-Neuro exam
-Catheters?
AP pelvis X-ray: if positive do inlet/outlet X-ray plus CT scan
-Transfer to major trauma center!

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9
Q

Where do most clavicle fractures occur?

A

Midshaft

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10
Q

How are clavicle fractures treated?

A

Conservatively:

  • Sling
  • Figure of 8
  • Open/vascular damage: surgery
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11
Q

How are shoulder separations classified?

A

Grades 1-3

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12
Q

How are shoulder separations treated?

A

Grade 1-2: sling, NSAIDS, PT

Grade 3: surgical option (athletes, high demand jobs)

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13
Q

How are SC joint separations treated?

A

Anterior: leave alone
Posterior: surgery; vascular area

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14
Q

What is the typical method of injury for scapula fractures?

A

Significant direct trauma

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15
Q

What fracture is associated with an 80% chance of there being another fracture/injury?

A

Scapula

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16
Q

Treat for scapula fracture?

A

X-ray: chest and shoulder 3V
Conservative unless glenoid
Glenoid: surgery

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17
Q

Who typically gets proximal humerus fractures?

A

Adults/Elderly

Little league pitchers (growth plate)

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18
Q

How are proximal humerus fractures treated?

A
  • Usually closed
  • Up to 50% displacement acceptable
  • If associated RC tear: treat delayed
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19
Q

What are the two most common dislocations seen in the ED?

A
  1. Fingers

2. Shoulder

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20
Q

What can cause posterior shoulder dislocations?

A

Electrocution

Sz

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21
Q

How to diagnose a posterior shoulder dislocation?

A

No external rotation

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22
Q

What is a Bankart’s lesion?

A

Chunk missing from glenoid

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23
Q

What tissues are often damaged in shoulder dislocations?

A
  • Axillary nerve
  • Musculocutaneous nerve
  • Brachial plexus
  • Axillary artery
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24
Q

Usual method of injury for shoulder dislocations?

A

FOOSH

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25
Treatment for shoulder dislocations?
- Reduction and immobilization - Refer to ortho: - X-ray - If Bankart's lesion: surgery (80% recurrence otherwise) - No lesion: agressive PT
26
What is the Hippocratic reduction technique?
Foot in shoulder (old school)
27
What muscles make up the rotator cuff muscles?
-SITS muscles
28
How many views of an injured shoulder do we always need?
3 views
29
What treatments are needed for full-thickness rotator cuff tears?
Arthroscopy or mini-open rotator-cuff repair
30
Treatment for general rotator cuff tears?
NSAIDS Rest Ice Cortisone shot?
31
How do you check if a patient's radial nerve is working?
They can give a thumb's up
32
What is the most common location for a humerus fracture?
Midshaft
33
How are closed humerus fractures treated?
- Coaptation splint | - Humeral fracture brace
34
What artery is often damaged in a supracondylar humerus fracture?
Brachial artery - Very spastic - Can lead to Volkmann's ischemic contractures
35
What is the usual method of injury for a supracondylar humerus fracture
-FOOSH plus elbow hyperextension
36
Treatment for supracondylar humerus fractures?
PEDS: cast, closed reduction plus cast, CRPP, ORIF Adults: ORIF
37
What is the most common elbow dislocation?
Posterior lateral | -Elbow extended, arm abducted, forearm supinated
38
Treatment for an elbow dislocation?
- Correct medial/lateral deformity - Flex elbow to 90 degrees, distal traction to correct A-P - Neuro exam - Splint at 90 degrees - Refer to ortho
39
What is nursemaid's elbow?
- Anterior subluxation of radial head - Excessive longitudinal traction - Usually before age 4
40
Treatment for forearm fractures?
- Usually radius AND ulna - Adults: ORIF (need perfect angle) - PEDS: can accept some angulation - Refer to ortho for a long arm cast
41
Treatment for radius fractures in peds?
-Reduction: can accept up to 15 degrees angulation
42
What type of fractures are most radial fractures?
Collie's - 90% - Dorsal angulation
43
Most common fracture?
Radius
44
What kind of scaphoid fractures have highest risk of AVN?
Waist fractures
45
Treatment for scaphoid fracture?
- Splint/cast that immobilizes thumb, wrist and elbow | - Displacement over 1mm: ORIF
46
What is a boxer's fracture?
5th MC fracture | -Bacteria from teeth: E. corrodens
47
Most common fracture of phalanges of hand?
Tuft's (distal)
48
Treatment of nail bed injury associated with distal phalanx fracture?
>50%: remove nail and repair | <50%: Burr hole
49
What is a mallet fracture?
- Downward blow to distal phalanx in extension - Avulsion of extensor tendon-isolate - Splint in extension and refer to hand surgeon
50
What is a Jersey fracture?
- Avulsion of distal flexor tendon - Finger splint - Surgery for all
51
Most common site for finger dislocation?
DIP joint (dorsal)
52
Gold standard for diagnosing carpal tunnel syndrome?
EMG
53
Treatment for carpal tunnel syndrome?
- Volar splint at night - NSAIDS - Steroids? - Surgery if nerve is compressed
54
What type are the majority of hip dislocations?
Posterior | -MVA; blow to flexed knees
55
How serious are hip dislocations?
Orthopedic emergency: risk of AVN
56
What signs/symptoms are virtually diagnostic of a hip fracture?
Groin pain plus trauma
57
How do patients with hip fractures present?
Shortened leg | External rotation of leg
58
Treatment for hip fractures?
- Buck's traction? - Peds: emergency; risk of AVN - Elderly: surgery when stable
59
In what patents do femoral head fractures occur?
- Distance runners - Eating disorders - Osteoporosis
60
Treatment for femur fractures?
- Children <6 y.o.-spica cast | - Adults-surgery
61
Treatment for patellar fractures?
Usually surgery: ORIF or patellaectomy
62
How serious is a knee dislocation?
- VERY - Complete separation of femur and tibia - Popliteal artery/nerve: vascular damage common - Orthopedic emergency
63
Characteristics of a meniscal injury?
``` -No instability + McMurray's, + Apley's compression test -Medial>Lateral -Inability to extend -Tx: knee arthroscopy ```
64
Gold standard for diagnosing a meniscal injury?
MRI
65
Most sensitive test for ACL injury?
Lachman's
66
Characteristics of a cruciate ligament injury?
- Pop + effusion + instability - Females>Males - ACL more common
67
Characteristics of collateral ligament injuries?
-MCL>LCL
68
Treatment for MCL or LCL injury?
- Brace - Rest - Ice - NSAIDS - Surgery rare
69
What nerve can be damaged in tibial plateau fracture?
Peronal
70
How do we test peronal nerve function?
Foot drop test
71
Characteristics of a tibial plateau fracture?
- Can be intra-articular or extra (usually intra) | - Usually lateral
72
Most common long bone fracture?
Tibia/fibula | -Shafts
73
Tx for tibia/fibula fractures?
- Usually surgery | - Toddler's fx, stress fx: casting
74
When an ankle fracture is suspected, how many x-ray views are needed?
3: | -Need posterior
75
What is syndesmosis disruption?
Instability of ankle ligaments Can lead to significant skin breakdown Can occur w/o fracture
76
What ligament is usually associated with ankle sprains?
Anterior talofibular
77
Characteristics of ankle sprains?
+ Anterior drawer | +Talar lift
78
What fracture is associated with ankle sprains?
Ottawa fracture
79
Characteristics of talus fracture?
- Emergency | - 20-50% risk of AVN
80
Treatment for talus fractures?
X-ray CT before surgery Can cast if non-displaced
81
What imaging should we use to evaluate a suspected calcaneous fracture?
CT
82
What is a Jones fracture?
Diaphysis junction of 5th metatarsal Inversion injury NWB Surgery
83
What is a LIsfranc injury?
- Midfoot - Rupture between base of 2nd metatarsal and medial cuneiform - Tenderness dorsally
84
Treatment for a LIsfranc injury?
Surgery
85
In which toe is it important to have perfect alignment?
Big toe

Surgery Test 1 (7 decks)

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