Ortho II Flashcards
True or false: the presentation of a radial-ulnar fracture is usually subtle
False—rarely subtle
What is the usual mechanism of injury with radial-ulnar fractures?
FOOSH!
What is a torus fracture?
Also known as buckle fractures, are incomplete fractures of the shaft of a long bone that is characterised by bulging of the cortex. They result from trabecular compression from an axial loading force along the long axis of the bone. They are usually seen in children, frequently involving the distal radial metaphysis.
What is the treatment for a child with a radial / ulnar fracture?
Cast
What is the treatment for an adult with a radial / ulnar fracture?
Surgical
What is the treatment for a child with a radial / ulnar torus fracture?
Splint
What is the usual mechanism that produces a wrist dislocation?
FOOSH!, or flexed hand as well
What are the views that should be obtained with suspected wrist fractures?
AP and lateral (oblique too per what’s her face)
What is the general treatment for wrist dislocations?
Splint and refer
Usually surgical
What is the usual mechanism that produces a wrist fracture?
FOOSH!
Why is there a risk of avascular necrosis with a scaphoid fracture?
Blood supply runs distal to proximal
What is the imaging modality of choice for diagnosing scaphoid fracture?
MRI
What is the usual mechanism of injury for metacarpal dislocations?
Fist fights
What is the treatment for a metacarpal dislocation?
Reduction, with gutter and splint
What are the complications that may arise from a metacarpal dislocation?
Inability to make a stable grasp
What is the usual mechanism of injury of metacarpal fractures?
Punching stuff
What are the physical exam findings characteristics of metacarpal fractures?
- Shaft palpably bent
- Receding knuckle
What is a boxer’s fracture?
colloquial term for a fracture of one of the metacarpal bones of the hand. Classically, the fracture occurs transversely across the neck of the bone, after the patient strikes an object with a closed fist.
What is the treatment for a boxer’s fracture?
Reduce, and then ulnar gutter splint with the finger extended and MPJ flexed
What motion of the finger cannot be performed if there is a finger dislocation?
“Come Here” motion
What is the treatment for finger dislocations?
Reduce it, then buddy tape it in the position of function
What is a major complication with bayonet fractures?
Tend to turn on themselves
What is the usual mechanism of injury for a pelvis injury?
Tremendous crush force
What is an open book fracture?
he left and right halves of the pelvis are separated at front and rear, the front opening more than the rear,
What is the treatment for an open book fractures?
Pelvic binder
- IVFs
- IR for embolization
What is the usual mechanism of injury for pelvic fractures?
Falling onto buttocks
What is the treatment for pelvic fractures?
Assist with ADLs, use a walker
What is the usual presentation of hip dislocations?
Foot internally rotated with a huge amount of pain
What x-ray views in particular must be obtained with hip dislocations?
Lateral
What is the major reason there is avascular necrosis with hip dislocations?
Medial circumflex runs through femoral head, and will kink or rupture with dislocation
What is the treatment for hip dislocations?
- Sedate and reduce
- Discuss with ortho
What is the usual presentation of hip fractures?
Leg is shortened and externally rotated
Why is the femoral head particularly susceptible to avascular necrosis?
Blood flow is retrograde
Where do femoral fractures usually occur?
Midshaft
What happens to the patella and quads with femoral shaft fractures?
Patella is displaced superiorly, and quads spasm
What is a hare traction splint?
Splint that applies traction for displace femur
What is the artery that is at risk with knee dislocations?
Popliteal–check distal pulses
What is the treatment for knee dislocations?
- Prompt reduction
- Assess for circulation
What is the Q angle?
Angle made between the lateral aspect of the body and axis through the femur
What is the treatment for a patellar dislocation?
Prompt reduction; press down on tibia, and wiggle the patella back into position
What are the muscles that should be exercised with patellar dislocations/
Quads
What is the treatment for knee fractures?
Knee immobilizer + ortho referral (total knee replacement needed)
Disability associated with patella fractures depends on what?
Capsular integrity
What is the usual mechanism of a tib-fib fractures?
Direct impact or torsion
What is the physical test that can be done to assess for tibial fracture?
Tapping should transmit–if not fractured (or just get a x-ray)
What is the treatment for a tib-fib fracture?
Pressure and immobility
Boot
What is the prognosis for calcaneal fx?
May not be able to bear weight again
What is the Bohler’s angle?
Angle between the superior surface of the calcaneus, and the axis between the calcaneus and the talus
What is a Dancer’s fractures?
Proximal 5th metatarsal fracture
What is the treatment for toe dislocations?
block and reduce, the buddy tape
What toe in particular may require pins if fractured?
Great toe
