Orthopedic Flashcards
What is the sensitivity of the Ottowa Ankle Rules
Approaches 100%
What are three criteria for Ottowa ankle rules in addition to PAIN in malleolar region.
- Tenderness in posterior 6cm medial malleolus or
- Tenderness in anterior 6cm of lateral malleolus or
- Inability to bear weight immediately and in the ED
What are the three criteria for the Ottowa foot rules in addition to PAIN in the midfoot region
- Tenderness at the base of the 5th metatarsal or
- Tenderness of the navicular or
- Inability to bear weight immediately and in the ED
Who should Ottowa ankle rules not be applied to?
- Intoxicated
- Multiple trauma
- Head injuries
- Decreased sensation/neuro deficit
What does comminuted mean?
A fracture with more than two pieces
In a patient that has a pulseless limb following a fracture, how can you try to restore blood flow?
You can try to gently reduce the fracture with gentle traction until blood flow is restored
What antibiotics should you use for open fractures?
- 1st generation cephalosporin (cefazolin)
2. Add aminoglycoside for Grade II and III fractures
How should you cover an open fracture?
With sterile wet dressing
What are the clinical symptoms of compartment syndrome?
Pain Pallor Paralysis Parasthesias Pulselessness
How do you diagnose compartment syndrome?
Pressure manometry
- Compartments usually ~ 0
- > 30 requires intervention
A femur can hold how much blood?
1000 ml
A pelvic fracture can hold how much blood?
3000 ml
Fractures of what bones are associated with avascular necrosis?
- Scaphoid
- Capitate
- Talus
- Femoral head
If you’re concerned about a fracture, but xrays are negative, what should you do?
Splint and reimage in 7-10 days
Why are splints better than casts in the ED?
They allow for soft-tissue swelling as the injury as the acute injury progresses
