ORTHO/NMS Flashcards
Describe type A fracture
Rotationally and vertically stable
Describe type A1 fractures
Fractures of the pelvis not involving the ring
Describe type A2 fractures
Stable, minimally displaced fractures of the ring
Describe type A3 fractures
Transverse sacral or coccyx fractures
Treatment for type A pelvic fractures
Bed rest until pain subsides (usually 3/52)
Pt mobilized PWB, NWB or FWB according to pain
Describe type B fractures
Rotationally unstable and vertically stable
Describe type B1 fractures
“Open book”
External rotation injury
Antero-posterior compression fractures
Causing separation of the public symphysis and widening or one or both sacroiliac joints
Treatment for type B fractures
If anterior gap is less than 2.5 cm then bedrest for 4/52 the mobilize according to pain
If anterior gap is bigger than 2.5cm external fixator for 6/52 or plates across public symphysis
Start mobilizing PWB
Describe type B2 fracture
Internal rotation injury
Ipsilateral compression
Causing the public bones to fracture and override
Describe type B3 fracture
Contraleteral compression injury
Resulting in public rami fractures on one side and compression sacroiliac joint injury on the other side
Treatment for B type fracturs
B2 and B3 (unstable)
ORIF/traction/ex-fix
CI & precaution for type B
No excessive hip external rotation
No sitting higher than 45 degrees hip flexion for 4/52
Describe type C pelvic fracture
Rotationally and vertically unstable
The pelvic ring is completely displaced at 2 or more points
Ligaments affected with C2
Posterior sacroiliac ligament
Sacrospinous ligament
Sacrotuberous ligament
Define spinal tumor
A growth of cells (mass) within or surrounding the spinal cord
Where can spinal tumors occur ?
Intramedullary
Extramedullary
Intradural
Extradural
Signs and symptoms of TB tumor
Back and neck pain
Numbness
Tingling and weakness in either arms
Clumsiness
Difficulty in walking
Incontinence
Treatment for spinal tumor
Steroids
Chemotherapy
Surgery
Radiotherapy
Signs and symptoms of TB
Appetite loss
Night sweats
Chest pains
Fever
Weight loss
Shortness of breath
Signs and symptoms of Pott’s disease
Fever
Night sweats
Localized back pain
Pain and stiffness
Paralysis of the lower limbs
Late complications of spinal tumor
Severe kyphosis
Vertebral collapse
Spinal cord compression
Sinus formation
Clinical complications of polytrauma
Haemorrhagic shock
Neurogenic shock
Multiple bone fractures
Primary or secondary head injury
Spinal cord injury
Auditory and visual damage
Unhealed wounds (sepsis)
Chest complications
Thoracic injuries
List anterior oblique sling muscles
Pectoralis
External oblique
Internal oblique
Abductors
(Provide stability in multidirections. Accelerating, rotating and decelerating body during change in direction)
List posterior oblique slings
Latissmus dorsi
Contralateral gluteus max and biceps femoris
Connected but thoracolumbar fascia
(Provides stability during gait)
List longitudinal slings
Multifidus
Deep layer of thoracolumbar fascia
Long head of biceps femoris
(Encourages SIJ to be in its close packed position)
List lateral sling muscles
Gluteus med
Abductors
Quadratus lamborum
(Provides pelvofemoral stability)
Why are thoracic disc lesions uncommon
Relatively thin disc
Mobility of the disc is limited by splinting of the ribcage
ALL, PLL and ligamentum flavum eell developed to provide stability
Nucleus Pulposus is more anterior than in other regions
Indications for spinal surgery
Instability
Stenosis
Failure of conservative management
Infections or tumors
Abnormal curvature of the spine
Name cervical tests you can do
Cervical AROM and PROM
cervical spine distraction test
Cervical spine spurling test
