Orthopedic Trauma Day 1 Flashcards
what does an open fracture require?
emergent orthopaedic care for surgical I&D and reduction
what is the treatment for an open fracture? (4)
irrigation at bedside with NS
wound dressing
IV antibiotics
tetanus
most shoulder dislocations (>90%) are classified as _____
anterior
shoulder dislocation puts what nerve at risk?
axillary nerve
what should always be done before and after a reduction?
neurovascular exam
what is the key to any reduction? (2)
relaxation
muscle fatigue
what is the treatment for shoulder dislocation? (2)
sling
gentle, progressive ROM exercises
what is the most common physical finding of a posterior shoulder dislocation?
shoulder locked in internal rotation
what must you get after any reduction?
xray
axillary view; is this an anterior or posterior dislocation?
anterior
axillary view; is this an anterior or posterior dislocation?
anterior
an injury of the anterior (inferior) glenoid labrum of the shoulder
bankart lesion
when does a bankart lesion occur?
when glenoid labrum is disrupted with shoulder dislocation
what is the treatment for bankart lesion?
surgery
a bankart lesion is often accompanied by a _____ _____
Hill-Sachs lesion
what is the arrow pointing at?
Bankart lesion
cortical depression in the posterolateral head of the humerus that results from forceful impaction of the humeral head against the glenoid rim when the shoulder is dislocated anteriorly
Hill-Sachs lesion
identify
Hill-Sachs lesion
how can most clavicle fractures be treated?
sling
which portion of the clavicle is most frequently injured?
middle
which 2 muscles assist in dislocation of the clavicle?
pectoralis going down
sternocleidomastoid going up
what should we check for on physical exam if a patient has a possible clavicle injury? (2)
to rule out what?
skin tenting + NV exam
to rule out brachial plexus injury
what imaging should we do for a fracture of the proximal clavicle? what joint should we examine?
CT scan
sternoclavicular joint
what is the treatment for a fracture of the proximal clavicle?
non-op
what is an absolute surgical indication for a fracture of the middle clavicle? (2)
open injury
impending open “skin tenting”
what are 5 relative surgical indications for a fracture of the middle clavicle?
> 2cm displaced
comminution
neuro compromise
nonunion with pain/limited ROM x 4 weeks
cosmetic/patient discomfort
identify
fracture of the middle clavicle
fracture of which part of the clavicle is most likely to nonunion?
distal clavicle
what is the most common treatment for fracture of the distal clavicle?
mostly non-op but controversial
displaced or non-displaced?
non-displaced
displaced or non-displaced?
displaced
a proximal humerus fracture is most common in which patients?
elderly with osteoporosis
injury to which nerve is most commonly associated with proximal humerus fracture?
axillary nerve
what is the most common treatment for proximal humerus fracture? (2)
non-op (sling and preserve ROM)
what does treatment for a proximal humerus fracture depend on? (7)
age
fracture type
fracture displacement
bone quality
dominance
general medical condition
concurrent injuries
a 72 yo patient presents with this. Dx? displaced vs non-displaced?
operative vs non-operative?
proximal humerus fracture
displaced
non-operative d/t age
what can we offer if a patient wants a surgical option for a proximal humerus fracture?
shoulder replacement
24 yo patient presents with this. Dx? operative vs nonoperative?
proximal humerus fracture w/ severe comminution
operative
