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Trauma > Ortho Trauma > Flashcards

Ortho Trauma Flashcards

1
Q

Anterior dislocation of shoulder may cause damage to which nerve?

A

axillary

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2
Q

What is the probable injury if can’t initiate abduction of shoulder?

A

Rotator cuff tear

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3
Q

What is the probable injury if wasting of deltoid?

A

axillary nerve paralysis

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4
Q

What is the probable injury if loss of deltoid contour?

A

Anterior shoulder dislocation

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5
Q

What is the probable injury if prominence of distal clavicle?

A

Acromio-clavicular dislocation

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6
Q

Name 5 hard signs vascular injury

A 
• Active pulsatile bleeding
• expanding pulsatile haematoma
. Shock with ongoing bleeding
• absent pulses or pulse deficit
• bruits/thrills over injured areas
Ischaemia
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7
Q

Name 5 soft signs vascular injury

A 
• History severe bleed
. Associated multiple fractures and soft tissue injury
• non expanding haematoma
• unexplained hypotension
• anatomical related structure injury
Associated nerve injury
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8
Q

Describe the Gustilo and Anderson classification of open fractures (5)

A

• Type 1: low energy, minimal soft tissue damage, wound <1 cm
• type 2: higher injury, laceration >1 cm, minimal contamination
• type 3 a: high energy, adequate soft tissue cover
• 3b: high energy, extensive soft tissue stripping, inadequate cover, massive contamination
Type 3 c: vascular injury requiring repair

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9
Q

Injury to radial nerve as in a humeral shaft fracture will result in what motorfollout?

A

Inability to extend and abduct thumb

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10
Q

Most Common type shoulder dislocation?

A

Anterior

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11
Q

Describe Colles fracture location, mechanism, risk groups, presentation, treatment.

A

ColleD
• Distal radius
• fall on outstretcheD hand while Dorsally flexed
• elDerly (osteoporosis)
• Dorsally displaced, Dorsally angulated, Dinner fork deformity, tender Distal forearm
• closeD reduction and cast

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12
Q

Treatment tibial plateau fractures?

A

ORIF

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13
Q

How can compartment syndrome be prevented?

A

Monovalent antiserum

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14
Q

Name 3 indications primary amputation

A
  • dead leg
  • 2 or more dead compartments infrapopliteal
  • mangled limb
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15
Q

Which antibiotic give for type 1 and 2 Gustilo Anderson open fracture?

A

Kefzol (cefazolin) or augmentin (co-amoxiclav)

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16
Q

Which antibiotic give for type 3 Gustilo Anderson open fracture?

A

Kefzol/augmentin plus gentamicin (clindanycin if penicillin allergy)

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17
Q

Which antibiotic give for rail track or farmyard injury?

A

Kefzol or augmenton and gentamicin and flagyl

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18
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 1 open fracture

A
  • low energy
  • <1cm
  • low soft tissue injury
  • no contamination
  • No comminution, simple pattern
  • soft tissue coverage
  • no vascular injury
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19
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 2 open fracture

A 
• moderate energy
• >1 cm
. Moderate soft tissue injury
• low contamination
• some comminution or simple fracture pattern
• soft tissue coverage
• no vascular injury
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20
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3a open fracture

A
  • High
  • > 10 cm
  • extensive
  • severe
  • severe/complex
  • yes
  • No
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21
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3b open fracture

A
  • high
  • > 10 cm
  • extensive
  • variable
  • severe/complex
  • no, require reconstruction
  • No
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22
Q

State energy of mechanism, wound size, soft tissue injury, contamination,comminution/fracture pattern, soft tissue coverage and vascular injury of Gustilo Anderson type 3c open fracture

A 
• High
• >10 cm
• extensive
• variable
• severe/complex
Variable
• yes, require reparation. Limb threatening
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23
Q

What constitutes unstable pelvic fracture?

A

Fractures that involve ring

24
Q

Tile classification of pelvic fractures? (3)

A

Type A: stable
Type B: rotationally unstable, vertically stable. Eg open book (ap compression) and lateral compression injuries
Type c: vertically and rotationally unstable.

25
Q

Name 2 signs urethral injury and investigation to confirm

A

• Blood urethral meatus
. High riding or floating prostate
Retrograde urethrogram

26
Q

Name 2 indications cystogram

A
  • Gross or substantial haematuria > 25 RBC / hpf

* hematoma and or free fluid in pelvis

27
Q

How test pelvic stability?

A

Gentle pressure on iliac wings. Only do once.

28
Q

How is pelvic binder/sheet tied?

A

• At level greater trochanters

. Strap legs in internal rotation, knees 30 degrees flexion

29
Q

Most Common type hip dislocation?

30
Q

Attitude of limb with post hip dislocation? (5)

A
  • Short
  • adducted
  • internally rotated
  • flexed hip
  • flexed knee
31
Q

Attitude of limb with ant hip dislocation? (3)

A
  • leg externally rotated
  • abducted
  • hip slightly flexed
32
Q

Treatment salter Harris 1 and 2?

A

Closed reduction and POP

33
Q

Treatment salter Harris 3 and 4?

34
Q

Most common fracture around elbow?

A

Supracondylar

35
Q

Sign on xray of supracondylar fracture?

A

Flag or fat pad sign

36
Q

Untreated supracondylar fractures may result in which deformity?

37
Q

What is Waddell’s triad?

A

• femur fracture
• Head injury
. Thoracic or abdominal injury

Present until otherwise proven

38
Q

In which children can gallows traction be used for femur fractures?

A
  • <12kg

* <2y

39
Q

In which children can pavlik harness be used for femur fractures?

A

<3 months age

40
Q

Most common salter Harris injury?

41
Q

Which 3 clavicle fractures are not treated conservatively?

A
  • Lateral 1/3
  • open
  • nv injury
42
Q

Garden hip injury classification?

A

Garden undisplaced: Shenton line intact but can see fracture

Garden displaced: disrupted shenton

43
Q

Treatment of garden undisplaced fracture in > 65 y?

A

In situ pinning (no reduction)

44
Q

Treatment of garden displaced fracture in > 65 y?

A

Community walker, active: total hip replacement

Home shuffler, frail: hemi-arthroplasty. Only replace femur head, not acetabulum

45
Q

Complication of deep penetrating injury of muscle mass?

A

Gas gangrene

46
Q

Anterior dislocation of shoulder may cause damage to which major structure most likely and most importantly?

A

Axillary nerve

47
Q

Name the 2 clinical features of viable muscles

A
  • capacity to bleed

* contractility

48
Q

Which important structure is commonly injured in post hip dislocation?

A

Sciatic nerve

49
Q

What type of splint is used for adults with midshaft femur fracture

A

Thomas splint.
May be used with either skin or skeletal traction. Should have groin ring circumference 3cm more than normal thigh circumference.

50
Q

Most important complication of intra- articular fracture?

A

Early onset rheumatoid arthritis

51
Q

Clinical presentation of posterior shoulder dislocation? (2)

A
  • Inability to abduct

* restriction external rotation

52
Q

How long wear posterior splint after elbow dislocation?

53
Q

Which side of tibial plateau is more commonly fractured?

54
Q

Which traction device is used for supracondylar humerus fractures in children?

A

Dunlop traction

55
Q

How long should pressure garments be worn? For burns

Trauma (21 decks)

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