Orthopaedics Flashcards
Describe the joint affected in anterior shoulder dislocation.
The glenohumeral joint is affected in anterior shoulder dislocation.
What muscle is affected in anterior shoulder dislocation causing inability to raise the arm above the head?
The deltoid muscle is affected.
How is reduction done in anterior shoulder dislocation?
Closed reduction followed by sling treatment is used.
Define the nerve affected in anterior shoulder dislocation leading to loss of sensation over the shoulder.
The axillary nerve is affected.
Describe the common causes of posterior shoulder dislocation.
It occurs in epileptics, electrical shock, or eclampsia.
What are the characteristic movements in posterior shoulder dislocation?
Adduction and internal rotation are characteristic movements.
What nerve is affected in a fracture of the surgical neck of the humerus?
The axillary nerve is affected.
How is a fracture of the surgical neck of the humerus typically treated?
It is treated with a triangular sling.
Describe the risk associated with humerus shaft fracture.
Wrist drop due to radial nerve injury is a risk.
What is the treatment for humerus shaft fracture?
A hanging arm cast is used for treatment.
When should child abuse be suspected in fractures?
Child abuse should be suspected.
cases of spiral fracture
What vascular impairment is associated with dislocated elbow?
Brachial artery impairment is associated.
How is a dislocated elbow typically treated?
Reduction under anesthesia is the typical treatment.
Describe the management approach for a green fracture in an adult involving the wrist and elbow.
Plaster cast
Define Colles’ fracture.
Fracture in old age postmenopausal females caused by a fall on an outstretched hand
How is reduction done for a stable fracture of the radius and ulna?
Disimpaction then traction the hand in a flexed position with ulnar deviation
What is the risk factor associated with Colles’ fracture?
Osteoporosis
Describe the shape associated with a Colles’ fracture.
Posterolateral displacement and angulation
What is the treatment for unstable fractures of the radius and ulna?
Surgery
For unstable fractures of the radius and ulna, particularly in older children where remodeling potential is minimal, the recommended treatment involves the following steps:
- Orthopaedic Advice and/or Referral: It is essential to seek orthopaedic advice or refer the patient to an orthopaedic service. This is especially important for greenstick and complete fractures, as well as for growth plate injuries and suspected Monteggia and Galeazzi injuries.
- Reduction and Immobilization: Unstable fractures often require reduction (realignment) of the bone fragments. Following reduction, immobilization is necessary to maintain the correct alignment. This is typically achieved using a well-molded cast or splints, sometimes extending above the elbow in younger children to prevent slippage.
- Follow-Up X-Rays: After reduction and cast application, follow-up X-rays are necessary to ensure that the fracture remains in the correct position. This usually includes one X-ray immediately after cast application if manipulation was required, and another follow-up X-ray after 7-10 days.
- Monitoring for Complications: Regular follow-up visits are needed to monitor for potential complications such as loss of reduction, growth disturbances, or improper healing.
For severe or complicated cases, surgical intervention may be required to stabilize the fracture using pins, plates, or screws.
Reference: AJGP-11-2020-Clinical-Selvakumaran-Buckled-Bent-Broken-WEB.pdf oai_citation:1,AJGP-11-2020-Clinical-Selvakumaran-Buckled-Bent-Broken-WEB.pdf.
How is a plaster cast positioned for a stable fracture of the radius and ulna?
Below elbow with pronated semi-flexed hand and ulnar deviation
Describe a scaphoid fracture.
It is the most common fractured carpal bone usually resulting from a fall on the outstretched hand.
What is the typical presentation of a scaphoid fracture?
Tenderness in the anatomical snuff box, with radiological changes appearing around 2 weeks after the injury.
What are the risks associated with a scaphoid fracture?
Avascular necrosis, proximal necrosis, and non-union.
How is a stable scaphoid fracture treated?
With a thumb spica cast.