Osseous conditions

Question 1

osteochondritis dissecans

Answer 1

associated with repetitive overhead or upper extremity weight bearing activities

gymnastics and throwing

repetitive trauma and or vascular insufficiency

20-25 yr
males> females

Question 2

osteochondritis dissecans presentation

Answer 2

complain of elbow pain

insidious, activity related onset that consists of pain, stiffness, possible effusion in lateral aspect of dominant UE

early on loss of extension
eventual catching, locking, grinding

Question 3

treatment for osteochondritis dissecans

Answer 3

relative rest and possible immobilization with gradual return

may require surgery for microfracture or drilling, fixation of lesion, debridement, OATS

Question 4

forearm fx types

Answer 4

nightstick
greenstick
monteggia
galeazzi
torus

Question 5

nightstick fx

Answer 5

midportion fx in ulna without other fx being present

often occurs from a direct blow to the ulna

Question 6

greenstick fx

Answer 6

incomplete fracture of one of the forearm bones due to flexibility of pediatric bones

Fracture occurs on the traction side of the injury

Often occurs during fall onto hand in children

Question 7

torus fx

Answer 7

buckle fracture that occurs when the bony cortex is compressed and fails, but does not extend into the traction side of the bone

Often occurs during fall onto hand in children

Question 8

monteggia fx

Answer 8

proximal ulna fracture with dislocation of radial head

Typically occurs when falling onto outstretched hand with elbow extended, and forearm pronated

HU jt- closed packed
HR jt- open packed

Question 9

galeazzi fx

Answer 9

distal or middle radius fracture with dislocation of the distal ulna at the wrist

typically occurs when falling onto hand with forearm pronated

Unable to be reproduced in laboratory setting

Question 10

colles fx

Answer 10

most common fracture of the wrist

Fracture occurs in distal radius
dorsal angulation of the distal fragment

we also include fracture of ulnar styloid

MOI- fall onto outstretched hand with wrist in extended position

consider median nerve

Question 11

smiths fx

Answer 11

fracture occurs in distal radius
palmar angulation of the distal fragment

MOI- Fall onto outstretched hand with wrist in flexed position

consider median nerve

Question 12

Frykmans classification tip

Answer 12

odd numbers- types of radius fx
even numbers- same radius fx but with ulnar styloid fx

Question 13

frykmans type 1 and type 2

Answer 13

1- Extra articular distal radius fracture

2- extra articular distal radius fx with ulnar styloid fx

Question 14

frykmans type 3 and 4

Answer 14

3- intra articular fx of distal radius extending into radiocarpal jt

4- same but add in ulnar styloid fx

Question 15

frykmans type 5 and 6

Answer 15

5- intra-articular radius fx that extends into the distal radio ulnar joint

6- same but with ulnar styloid fx

Question 16

frykmans type 7 and 8

Answer 16

7- distal radius intra articular fracture that extends into both the radiocarpal and distal radio ulnar joints

8- same but with fx in u styloid

Question 17

scaphoid fx

Answer 17

most common carpal fx

Typically occurs due to fall on outstretched hand

Three possible fracture locations

Poor blood supply in proximal pole as it relies on retrograde blood flow from radial artery
Increases risk for avascular necrosis

Question 18

scaphoid fractures implications and examination

Answer 18

Of the difficult to see on x-rays
Recommended to treat as a fracture until proven otherwise

Immobilize one to two weeks with repeated imaging and clinical examination

anatomic snuffbox pain felt with ulnar deviation within 72 hours
scaphoid tubercle tenderness at two weeks

Question 19

boxers fracture

Answer 19

Fracture of the fifth metacarpal (4th uncommon)

can be present anywhere along the shaft

Usually involves displacement

Occurs as a result of hitting an object with a closed fist

Question 20

bennet fx

Answer 20

fracture of the base of the first metacarpal
Partial intra-articular

Typically a result of trauma involving axial loading through the thumb

Question 21

rolando fx

Answer 21

fracture of the base of the first metacarpal that results in three fragments of bone

Fully intra-articular

Typically a result of trauma involving axial loading through the thumb