Ortho Flashcards
A splintered or crushed fracture is known as a _____ fracture.
Comminuted
____ is the study of choice for the dx of an occult hip fx.
MRI
The treatment of simple fractures often involves:
Closed reduction with cast placement
Complicated or unstable fractures require:
ORIF
_____ (type of fracture) occurs when one side of the cortex buckles as a result of compression injury (e.g. FOOSH). Differs from a greenstick fracture by the mechanism of injury.
Torus fracture
*Treatment= 4-6 weeks in cast
____ (type of fracture) occurs in long bones when bowing causes a break in one side of the cortex.
Greenstick fx
*If angulation >15 degrees you need referral to an ortho surgeon
Salter-Harris fractures involve the growth plate of long bones in pediatric patients. The classification is:
• I → entire physis
• II → entire physis + portion of metaphysis
• III → portion of the epiphysis
• IV → portion of epiphysis + portion of the metaphysis
• V → compression injury of epiphyseal plate
S-A-L-TE-R
S- Straight across A- Above (Most common!) L- Lower TE- Through Everything R- cRush
Dislocation v. Subluxation…
o Dislocation → total loss of congruity that occurs between the articular surfaces of the joint
o Subluxation → any less serious loss of congruity, or a less than complete dislocation.
____ is the MC type of shoulder dislocation.
Anterior glenohumeral
*Humeral head is anterior and inferior to glenoid
Clinical manifestation of an anterior shoulder dislocation is:
Arm is ABDUCTED, EXTERNALLY ROTATED
How is an anterior shoulder dislocation managed?
Reduction
*Must RULE OUT axillary nerve injury
A posterior shoulder dislocation is most commonly associated with _____ (type of medical event).
Seizures (electric shock and trauma)
Clinical manifestations of a posterior shoulder dislocation are:
Arm ADDUCTED, INTERNALLY ROTATED; Anterior shoulder is flat, humeral head is prominent
*Management- reduction and immobilization
Axillary and Y views are the most helpful in determining _____ v. _____ dislocations.
Anterior v. Posterior Shoulder
_____ injuries are MC in athletes or laborers performing repetitive overhead movements. They are the MC cause of shoulder pain in people > 40y.
Rotator cuff
*SUPRASPINATUS MC!!
Some PE findings with rotator cuff injuries include:
- Passive ROM greater than active!
- Supraspinatus strength test- empty can test
- Impingement tests of subscapular nerve/supraspinatus:
- Hawkins test
- Drop arm test
- Neer test - Subacromial lidocaine test: can help distinguish tendinopathy from tears (normal strength with pain relief= tendinopathy)
Management of tedinitis and tears includes:
- Tendinitis: shoulder pendulum/wall climbing exercises, ice, NSAIDs, stop offending activity
- Tear: Conservative- rehab, NSAIDs, intraarticular corticosteroids, ROM preservation- surgery
AC joint dislocation (“shoulder separation”) dx using ____ to reveal mild separations.
Weights
There are 5 classes of AC joint dislocation that progressively worsen (5 is worse than 1). In class ___ the AC ligament is ruptured and the coracoclavicular ligament is sprained.
2
*Class 3- Rupture of BOTH AC and CC ligaments- may need SURGERY
In humeral shaft fractures you must r/o ___ nerve injury. This injury may cause wrist drop.
Radial nerve
*Check deltoid sensation to assess for brachial plexus injury
The MOI for humeral shaft fractures is:
FOOSH or direct trauma
The MC fractured bone in children, adolescents, and newborns during birth is the _____.
Clavicle
*If proximal 1/3 get ortho consult
Thoracic outlet syndrome can cause nerve compression, especially on ____ side of hand.
Ulnar
A PE of Thoracic Outlet Syndrome may reveal a positive Adson sign which is:
Loss of radial pulse with head rotation to affected side.
*TOS diagnosed by MRI