Orthopaedic Trauma Day 2 Flashcards
what nerve is at most risk in a humeral shaft fracture?
radial nerve
what kind of angulation is most common in a humeral shaft fracture?
varus angulation
what is the treatment for a humeral shaft fracture?
brace (allow for healing)
identify fracture and determine if displaced or not
humeral shaft fracture
not displaced/minimally displaced
identify fracture and determine if displaced or not
humeral shaft fracture
displaced
when is surgery indicated for a humeral shaft fracture? (5)
open
brachial plexus injury
varsus/valgus >30 degrees
ipsilateral forearm fracture (floating elbow)
compartment syndrome
what is at risk during surgery of a humeral shaft fracture?
radial nerve injury
identify fracture. treatment and why?
humeral shaft fracture
surgical management d/t angulation
identify fracture. treatment and why?
humeral shaft fracture
surgical management d/t angulation
identify fracture. treatment and why?
humeral shaft fracture
surgical management d/t open fracture
xray finding that is associated with intra-articular trauma to the elbow
fat pad sign
indicates elbow joint effusion, suggesting occult non-displaced intra-articular fracture
anterior fat pad sign (sail sign)
suggests occult non-displaced fracture
posterior fat pad sign
what kind of fracture occurs in children with a posterior fat pad sign?
condylar fracture
what kind of fracture occurs in adults with a posterior fat pad sign?
radial head fractures
identify arrows
anterior and posterior fat pad signs
what does an anterior or posterior fat pad sign indicate?
swelling - fracture near the elbow
what is the most common fracture of the elbow in adults?
radial head fracture
a patient presents with limitations in extension and supination of their arm, it is tender to palpation over lateral elbow. Dx?
radial head fracture
what is the treatment for radial head fracture?
sling and start ROM
Dx?
radial head fracture
leads to separation of the triceps and brachialis and loss of extensor mechanism of the elbow
olecranon fracture
what is the non-operative treatment for olecranon fractures?
long arm splint at 45 degrees
in which 2 cases does an olecranon fracture need surgical management?
displaced
loss of extensor mechanism
identify fracture. displaced vs nondisplaced?
olecranon fracture
non-displaced
identify fracture. displaced vs nondisplaced?
olecranon fracture
displaced
what is the most common dislocation in kids?
elbow dislocation
what is the 2nd most common dislocation in adults?
elbow dislocation
are most elbow dislocations anterior or posterior? why?
posterior
olecranon is big enough to go through coronoid process
are elbows most likely to dislocate while flexed or extended? why?
extended
weaker position
identify
elbow dislocation
where should we check for potential fracture with an xray if a patient has a dislocated elbow?
coronoid process
how is an elbow dislocation most commonly treated initially?
closed reduction with sedation
what is the non-op management for a dislocated elbow? (2)
splint in 90 degrees x7-10 days
early ROM
what is the most common complication of an elbow dislocation?
loss of elbow extension
what are some indications for surgical management of an elbow dislocation? (3)
complex fracture
persistent instability post reduction
failed closed reduction
when both the radius and ulnar shaft are broken
both bone forearm fracture
what is the universal treatment for a both bone forearm fracture in adults?
surgery
what is the initial management of a both bone forearm fracture in an adult? (2)
NV exam
compartment syndrome evaluation
what splint can be used for a both bone forearm fracture in adults?
sugar tong splint
splint that prevents flexion and extension of the wrist and elbow and supination/pronation
sugar tong splint
identify
both bone forearm fracture
a very common fracture that makes parents hysterical since there is a visible deformity of the arm in their kid
both bone forearm fracture
what should always be done for a both bone forearm fracture in kids?
always xray elbow and wrist
what is the preferred treatment of a both bone forearm fracture in a kid?
splint
accept much higher degrees of deformity during a closed reduction than in adults
what is a surgical option for a both bone forearm fracture in a kid?
flexible intermedullary nailing
what is the most common fracture in the lower forearm in young children?
buckle fracture of distal metaphysis of radius and ulna
how is a buckle fracture in kids managed? (2)
volar splint
OR
short arm cast
incomplete fracture of the cortex typically in children and commonly in the radius or ulna
greenstick fracture
why must we be careful during reduction of a greenstick fracture?
may overcorrect and cause a complete fracture
what is the treatment for a greenstick fracture?
long arm cast
identify
greenstick fracture
identify
buckle fracture
identify
buckle fracture
identify
greenstick fracture
fracture of the distal 1/3 radial shaft with injury of the distal radioulnar joint
galeazzi fracture
what is the treatment for a galeazzi fracture?
open reduction and internal fixation (ORIF)
what splint can be used for a galeazzi fracture?
sugar tong splint
identify
galeazzi fracture
what type of variance is seen in this galeazzi fracture?
ulnar variance
ulna is taller than radius
identify
galeazzi fracture
fracture of the proximal 1/3 of the ulna with dislocation of the radial head
monteggia fracture
what is the treatment for a monteggia fracture? (2)
sugar tong splint
surgery
identify
monteggia fracture
identify
monteggia fracture
ulnar shaft fracture typically at the distal 1/3 junction
nightstick fracture
what is the treatment for a nightstick fracture? (2)
sugar splint
ortho referral/surgery
identify
nightstick fracture
identify
nightstick fracture
what is a risk factor for a distal radius fracture?
osteoporosis
what is the immediate initial treatment for a distal radius fracture? (2)
reduce
immobilize with sugar tong splint
if a patient has a distal radius fracture, extreme flexion of the wrist and ulnar deviation increases the risk of what?
carpal tunnel syndrome
identify
ulnar variance
identify
distal radius fracture
transverse distal radius fracture that is dorsally displaced and extra-articular
colles’ fracture
transverse distal radius fracture that is volarly displaced and extra-articular
smith’s fracture
fracture-dislocation of the radiocarpal joint that is intra-articular and can be displaced dorsal or volar
barton’s fracture
fracture of the radial styloid
chauffer’s fracture
identify and describe
colles’ fracture
transverse fracture of distal radius, dorsally displaced and extra-articular
identify and describe
smith’s fracture
transverse fracture of the distal radius, volarly displaced and (should be) extra-articular but is intra-articular
a patient presents with a dinner fork deformity. what is it?
colles’ fracture
identify and describe
chauffer’s fracture
fracture of the radial styloid
what is the most common carpal bone fracture?
scaphoid bone fracture
a patient presents with pain in the anatomical snuff box. Dx?
scaphoid bone fracture
why is a scaphoid bone fracture important to notice? (3)
blood supply
high incidence of avascular necrosis
high incidence of nonunion
what should we do for management since a scaphoid bone fracture is commonly an occult fracture? (2)
thumb spica splint
re-xray in 2 weeks
what location of the scaphoid bone has a high risk for nonunion if fractured?
proximal fracture of scaphoid bone
identify
middle scaphoid fracture
what is the non-op management for a scaphoid fracture? (3)
long arm thumb spica cast x 6 weeks
short arm thumb spica cast x 6 weeks
removable thumb spica splint x 4-6 weeks
how long is the healing time for a scaphoid fracture?
18 weeks + rehab
what is the surgical treatment for a scaphoid fracture?
screw placement
return to work sooner
still high rate of AVN and nonunion
what does AVN or nonunion of a scaphoid fracture increase the risk for? (2)
wrist arthritis
unstable wrist joint
identify
displaced scaphoid fracture
