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Ortho-Rheum > Orthopaedic Trauma Day 2 > Flashcards

Orthopaedic Trauma Day 2 Flashcards

1
Q

what nerve is at most risk in a humeral shaft fracture?

A

radial nerve

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2
Q

what kind of angulation is most common in a humeral shaft fracture?

A

varus angulation

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3
Q

what is the treatment for a humeral shaft fracture?

A

brace (allow for healing)

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4
Q

identify fracture and determine if displaced or not

A

humeral shaft fracture
not displaced/minimally displaced

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5
Q

identify fracture and determine if displaced or not

A

humeral shaft fracture
displaced

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6
Q

when is surgery indicated for a humeral shaft fracture? (5)

A

open
brachial plexus injury
varsus/valgus >30 degrees
ipsilateral forearm fracture (floating elbow)
compartment syndrome

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7
Q

what is at risk during surgery of a humeral shaft fracture?

A

radial nerve injury

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8
Q

identify fracture. treatment and why?

A

humeral shaft fracture
surgical management d/t angulation

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9
Q

identify fracture. treatment and why?

A

humeral shaft fracture
surgical management d/t angulation

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10
Q

identify fracture. treatment and why?

A

humeral shaft fracture
surgical management d/t open fracture

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11
Q

xray finding that is associated with intra-articular trauma to the elbow

A

fat pad sign

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12
Q

indicates elbow joint effusion, suggesting occult non-displaced intra-articular fracture

A

anterior fat pad sign (sail sign)

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13
Q

suggests occult non-displaced fracture

A

posterior fat pad sign

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14
Q

what kind of fracture occurs in children with a posterior fat pad sign?

A

condylar fracture

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15
Q

what kind of fracture occurs in adults with a posterior fat pad sign?

A

radial head fractures

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16
Q

identify arrows

A

anterior and posterior fat pad signs

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17
Q

what does an anterior or posterior fat pad sign indicate?

A

swelling - fracture near the elbow

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18
Q

what is the most common fracture of the elbow in adults?

A

radial head fracture

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19
Q

a patient presents with limitations in extension and supination of their arm, it is tender to palpation over lateral elbow. Dx?

A

radial head fracture

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20
Q

what is the treatment for radial head fracture?

A

sling and start ROM

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21
Q

Dx?

A

radial head fracture

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22
Q

leads to separation of the triceps and brachialis and loss of extensor mechanism of the elbow

A

olecranon fracture

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23
Q

what is the non-operative treatment for olecranon fractures?

A

long arm splint at 45 degrees

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24
Q

in which 2 cases does an olecranon fracture need surgical management?

A

displaced
loss of extensor mechanism

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25
Q

identify fracture. displaced vs nondisplaced?

A

olecranon fracture
non-displaced

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26
Q

identify fracture. displaced vs nondisplaced?

A

olecranon fracture
displaced

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27
Q

what is the most common dislocation in kids?

A

elbow dislocation

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28
Q

what is the 2nd most common dislocation in adults?

A

elbow dislocation

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29
Q

are most elbow dislocations anterior or posterior? why?

A

posterior
olecranon is big enough to go through coronoid process

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30
Q

are elbows most likely to dislocate while flexed or extended? why?

A

extended
weaker position

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31
Q

identify

A

elbow dislocation

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32
Q

where should we check for potential fracture with an xray if a patient has a dislocated elbow?

A

coronoid process

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33
Q

how is an elbow dislocation most commonly treated initially?

A

closed reduction with sedation

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34
Q

what is the non-op management for a dislocated elbow? (2)

A

splint in 90 degrees x7-10 days
early ROM

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35
Q

what is the most common complication of an elbow dislocation?

A

loss of elbow extension

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36
Q

what are some indications for surgical management of an elbow dislocation? (3)

A

complex fracture
persistent instability post reduction
failed closed reduction

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37
Q

when both the radius and ulnar shaft are broken

A

both bone forearm fracture

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38
Q

what is the universal treatment for a both bone forearm fracture in adults?

A

surgery

39
Q

what is the initial management of a both bone forearm fracture in an adult? (2)

A

NV exam
compartment syndrome evaluation

40
Q

what splint can be used for a both bone forearm fracture in adults?

A

sugar tong splint

41
Q

splint that prevents flexion and extension of the wrist and elbow and supination/pronation

A

sugar tong splint

42
Q

identify

A

both bone forearm fracture

43
Q

a very common fracture that makes parents hysterical since there is a visible deformity of the arm in their kid

A

both bone forearm fracture

44
Q

what should always be done for a both bone forearm fracture in kids?

A

always xray elbow and wrist

45
Q

what is the preferred treatment of a both bone forearm fracture in a kid?

A

splint

accept much higher degrees of deformity during a closed reduction than in adults

46
Q

what is a surgical option for a both bone forearm fracture in a kid?

A

flexible intermedullary nailing

47
Q

what is the most common fracture in the lower forearm in young children?

A

buckle fracture of distal metaphysis of radius and ulna

48
Q

how is a buckle fracture in kids managed? (2)

A

volar splint
OR
short arm cast

49
Q

incomplete fracture of the cortex typically in children and commonly in the radius or ulna

A

greenstick fracture

50
Q

why must we be careful during reduction of a greenstick fracture?

A

may overcorrect and cause a complete fracture

51
Q

what is the treatment for a greenstick fracture?

A

long arm cast

52
Q

identify

A

greenstick fracture

53
Q

identify

A

buckle fracture

54
Q

identify

A

buckle fracture

55
Q

identify

A

greenstick fracture

56
Q

fracture of the distal 1/3 radial shaft with injury of the distal radioulnar joint

A

galeazzi fracture

57
Q

what is the treatment for a galeazzi fracture?

A

open reduction and internal fixation (ORIF)

58
Q

what splint can be used for a galeazzi fracture?

A

sugar tong splint

59
Q

identify

A

galeazzi fracture

60
Q

what type of variance is seen in this galeazzi fracture?

A

ulnar variance

ulna is taller than radius

61
Q

identify

A

galeazzi fracture

62
Q

fracture of the proximal 1/3 of the ulna with dislocation of the radial head

A

monteggia fracture

63
Q

what is the treatment for a monteggia fracture? (2)

A

sugar tong splint
surgery

64
Q

identify

A

monteggia fracture

65
Q

identify

A

monteggia fracture

66
Q

ulnar shaft fracture typically at the distal 1/3 junction

A

nightstick fracture

67
Q

what is the treatment for a nightstick fracture? (2)

A

sugar splint
ortho referral/surgery

68
Q

identify

A

nightstick fracture

69
Q

identify

A

nightstick fracture

70
Q

what is a risk factor for a distal radius fracture?

A

osteoporosis

71
Q

what is the immediate initial treatment for a distal radius fracture? (2)

A

reduce
immobilize with sugar tong splint

72
Q

if a patient has a distal radius fracture, extreme flexion of the wrist and ulnar deviation increases the risk of what?

A

carpal tunnel syndrome

73
Q

identify

A

ulnar variance

74
Q

identify

A

distal radius fracture

75
Q

transverse distal radius fracture that is dorsally displaced and extra-articular

A

colles’ fracture

76
Q

transverse distal radius fracture that is volarly displaced and extra-articular

A

smith’s fracture

77
Q

fracture-dislocation of the radiocarpal joint that is intra-articular and can be displaced dorsal or volar

A

barton’s fracture

78
Q

fracture of the radial styloid

A

chauffer’s fracture

79
Q

identify and describe

A

colles’ fracture

transverse fracture of distal radius, dorsally displaced and extra-articular

80
Q

identify and describe

A

smith’s fracture

transverse fracture of the distal radius, volarly displaced and (should be) extra-articular but is intra-articular

81
Q

a patient presents with a dinner fork deformity. what is it?

A

colles’ fracture

82
Q

identify and describe

A

chauffer’s fracture

fracture of the radial styloid

83
Q

what is the most common carpal bone fracture?

A

scaphoid bone fracture

84
Q

a patient presents with pain in the anatomical snuff box. Dx?

A

scaphoid bone fracture

85
Q

why is a scaphoid bone fracture important to notice? (3)

A

blood supply
high incidence of avascular necrosis
high incidence of nonunion

86
Q

what should we do for management since a scaphoid bone fracture is commonly an occult fracture? (2)

A

thumb spica splint
re-xray in 2 weeks

87
Q

what location of the scaphoid bone has a high risk for nonunion if fractured?

A

proximal fracture of scaphoid bone

88
Q

identify

A

middle scaphoid fracture

89
Q

what is the non-op management for a scaphoid fracture? (3)

A

long arm thumb spica cast x 6 weeks

short arm thumb spica cast x 6 weeks

removable thumb spica splint x 4-6 weeks

90
Q

how long is the healing time for a scaphoid fracture?

A

18 weeks + rehab

91
Q

what is the surgical treatment for a scaphoid fracture?

A

screw placement

return to work sooner
still high rate of AVN and nonunion

92
Q

what does AVN or nonunion of a scaphoid fracture increase the risk for? (2)

A

wrist arthritis
unstable wrist joint

93
Q

identify

A

displaced scaphoid fracture

Ortho-Rheum (27 decks)

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