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Surgery Test 1 > Ortho 2 > Flashcards

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
Q

Treatment for shoulder dislocations?

A
  • Reduction and immobilization
  • Refer to ortho:
    • X-ray
    • If Bankart’s lesion: surgery (80% recurrence otherwise)
    • No lesion: agressive PT
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26
Q

What is the Hippocratic reduction technique?

A

Foot in shoulder (old school)

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27
Q

What muscles make up the rotator cuff muscles?

A

-SITS muscles

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28
Q

How many views of an injured shoulder do we always need?

A

3 views

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29
Q

What treatments are needed for full-thickness rotator cuff tears?

A

Arthroscopy or mini-open rotator-cuff repair

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30
Q

Treatment for general rotator cuff tears?

A

NSAIDS
Rest
Ice
Cortisone shot?

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31
Q

How do you check if a patient’s radial nerve is working?

A

They can give a thumb’s up

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32
Q

What is the most common location for a humerus fracture?

A

Midshaft

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33
Q

How are closed humerus fractures treated?

A
  • Coaptation splint

- Humeral fracture brace

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34
Q

What artery is often damaged in a supracondylar humerus fracture?

A

Brachial artery

  • Very spastic
  • Can lead to Volkmann’s ischemic contractures
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35
Q

What is the usual method of injury for a supracondylar humerus fracture

A

-FOOSH plus elbow hyperextension

36
Q

Treatment for supracondylar humerus fractures?

A

PEDS: cast, closed reduction plus cast, CRPP, ORIF
Adults: ORIF

37
Q

What is the most common elbow dislocation?

A

Posterior lateral

-Elbow extended, arm abducted, forearm supinated

38
Q

Treatment for an elbow dislocation?

A
  • 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
Q

What is nursemaid’s elbow?

A
  • Anterior subluxation of radial head
  • Excessive longitudinal traction
  • Usually before age 4
40
Q

Treatment for forearm fractures?

A
  • Usually radius AND ulna
  • Adults: ORIF (need perfect angle)
  • PEDS: can accept some angulation
  • Refer to ortho for a long arm cast
41
Q

Treatment for radius fractures in peds?

A

-Reduction: can accept up to 15 degrees angulation

42
Q

What type of fractures are most radial fractures?

A

Collie’s

  • 90%
  • Dorsal angulation
43
Q

Most common fracture?

A

Radius

44
Q

What kind of scaphoid fractures have highest risk of AVN?

A

Waist fractures

45
Q

Treatment for scaphoid fracture?

A
  • Splint/cast that immobilizes thumb, wrist and elbow

- Displacement over 1mm: ORIF

46
Q

What is a boxer’s fracture?

A

5th MC fracture

-Bacteria from teeth: E. corrodens

47
Q

Most common fracture of phalanges of hand?

A

Tuft’s (distal)

48
Q

Treatment of nail bed injury associated with distal phalanx fracture?

A

> 50%: remove nail and repair

<50%: Burr hole

49
Q

What is a mallet fracture?

A
  • Downward blow to distal phalanx in extension
  • Avulsion of extensor tendon-isolate
  • Splint in extension and refer to hand surgeon
50
Q

What is a Jersey fracture?

A
  • Avulsion of distal flexor tendon
  • Finger splint
  • Surgery for all
51
Q

Most common site for finger dislocation?

A

DIP joint (dorsal)

52
Q

Gold standard for diagnosing carpal tunnel syndrome?

A

EMG

53
Q

Treatment for carpal tunnel syndrome?

A
  • Volar splint at night
  • NSAIDS
  • Steroids?
  • Surgery if nerve is compressed
54
Q

What type are the majority of hip dislocations?

A

Posterior

-MVA; blow to flexed knees

55
Q

How serious are hip dislocations?

A

Orthopedic emergency: risk of AVN

56
Q

What signs/symptoms are virtually diagnostic of a hip fracture?

A

Groin pain plus trauma

57
Q

How do patients with hip fractures present?

A

Shortened leg

External rotation of leg

58
Q

Treatment for hip fractures?

A
  • Buck’s traction?
  • Peds: emergency; risk of AVN
  • Elderly: surgery when stable
59
Q

In what patents do femoral head fractures occur?

A
  • Distance runners
  • Eating disorders
  • Osteoporosis
60
Q

Treatment for femur fractures?

A
  • Children <6 y.o.-spica cast

- Adults-surgery

61
Q

Treatment for patellar fractures?

A

Usually surgery: ORIF or patellaectomy

62
Q

How serious is a knee dislocation?

A
  • VERY
  • Complete separation of femur and tibia
  • Popliteal artery/nerve: vascular damage common
  • Orthopedic emergency
63
Q

Characteristics of a meniscal injury?

A 
-No instability
\+ McMurray's, + Apley's compression test
-Medial>Lateral
-Inability to extend
-Tx: knee arthroscopy
64
Q

Gold standard for diagnosing a meniscal injury?

A

MRI

65
Q

Most sensitive test for ACL injury?

A

Lachman’s

66
Q

Characteristics of a cruciate ligament injury?

A
  • Pop + effusion + instability
  • Females>Males
  • ACL more common
67
Q

Characteristics of collateral ligament injuries?

A

-MCL>LCL

68
Q

Treatment for MCL or LCL injury?

A
  • Brace
  • Rest
  • Ice
  • NSAIDS
  • Surgery rare
69
Q

What nerve can be damaged in tibial plateau fracture?

A

Peronal

70
Q

How do we test peronal nerve function?

A

Foot drop test

71
Q

Characteristics of a tibial plateau fracture?

A
  • Can be intra-articular or extra (usually intra)

- Usually lateral

72
Q

Most common long bone fracture?

A

Tibia/fibula

-Shafts

73
Q

Tx for tibia/fibula fractures?

A
  • Usually surgery

- Toddler’s fx, stress fx: casting

74
Q

When an ankle fracture is suspected, how many x-ray views are needed?

A

3:

-Need posterior

75
Q

What is syndesmosis disruption?

A

Instability of ankle ligaments
Can lead to significant skin breakdown
Can occur w/o fracture

76
Q

What ligament is usually associated with ankle sprains?

A

Anterior talofibular

77
Q

Characteristics of ankle sprains?

A

+ Anterior drawer

+Talar lift

78
Q

What fracture is associated with ankle sprains?

A

Ottawa fracture

79
Q

Characteristics of talus fracture?

A
  • Emergency

- 20-50% risk of AVN

80
Q

Treatment for talus fractures?

A

X-ray
CT before surgery
Can cast if non-displaced

81
Q

What imaging should we use to evaluate a suspected calcaneous fracture?

A

CT

82
Q

What is a Jones fracture?

A

Diaphysis junction of 5th metatarsal
Inversion injury
NWB
Surgery

83
Q

What is a LIsfranc injury?

A
  • Midfoot
  • Rupture between base of 2nd metatarsal and medial cuneiform
  • Tenderness dorsally
84
Q

Treatment for a LIsfranc injury?

A

Surgery

85
Q

In which toe is it important to have perfect alignment?

A

Big toe

Surgery Test 1 (7 decks)

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