Ortho Trauma Flashcards
Anterior dislocation of shoulder may cause damage to which nerve?
axillary
What is the probable injury if can’t initiate abduction of shoulder?
Rotator cuff tear
What is the probable injury if wasting of deltoid?
axillary nerve paralysis
What is the probable injury if loss of deltoid contour?
Anterior shoulder dislocation
What is the probable injury if prominence of distal clavicle?
Acromio-clavicular dislocation
Name 5 hard signs vascular injury
• Active pulsatile bleeding • expanding pulsatile haematoma . Shock with ongoing bleeding • absent pulses or pulse deficit • bruits/thrills over injured areas Ischaemia
Name 5 soft signs vascular injury
• History severe bleed . Associated multiple fractures and soft tissue injury • non expanding haematoma • unexplained hypotension • anatomical related structure injury Associated nerve injury
Describe the Gustilo and Anderson classification of open fractures (5)
• 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
Injury to radial nerve as in a humeral shaft fracture will result in what motorfollout?
Inability to extend and abduct thumb
Most Common type shoulder dislocation?
Anterior
Describe Colles fracture location, mechanism, risk groups, presentation, treatment.
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
Treatment tibial plateau fractures?
ORIF
How can compartment syndrome be prevented?
Monovalent antiserum
Name 3 indications primary amputation
- dead leg
- 2 or more dead compartments infrapopliteal
- mangled limb
Which antibiotic give for type 1 and 2 Gustilo Anderson open fracture?
Kefzol (cefazolin) or augmentin (co-amoxiclav)
Which antibiotic give for type 3 Gustilo Anderson open fracture?
Kefzol/augmentin plus gentamicin (clindanycin if penicillin allergy)
Which antibiotic give for rail track or farmyard injury?
Kefzol or augmenton and gentamicin and flagyl
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
- low energy
- <1cm
- low soft tissue injury
- no contamination
- No comminution, simple pattern
- soft tissue coverage
- no vascular injury
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
• moderate energy • >1 cm . Moderate soft tissue injury • low contamination • some comminution or simple fracture pattern • soft tissue coverage • no vascular injury
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
- High
- > 10 cm
- extensive
- severe
- severe/complex
- yes
- No
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
- high
- > 10 cm
- extensive
- variable
- severe/complex
- no, require reconstruction
- No
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
• High • >10 cm • extensive • variable • severe/complex Variable • yes, require reparation. Limb threatening