random Flashcards
When evaluating for AC joint injury, what xray view should be used along with a shoulder series?
A Zanca view can be taken to better visualize the distal clavicle. This is done with the beam 10 to 15 degrees cephalad
indications for operative management of clavicle fx
- open
- neurovascular injury
- skin tenting
- displacement of > 100%
- shortening of > 2 cm
most brachial plexus injuries are associated with clavicle fx of what location
medial 1/3
Dislocation of medial 1/3 clavicle in what direction is more serious and required operative management along with cardiothoracic surgery consult
posterior displacement
how do pts with glenohumeral anterior dislocation hold their arm
ABducted and external rotation
What view needs to be ordered to catch posterior glenohumeral dislocation?
Axillary view
Regular x-rays may miss posterior glenohumeral dislocations. If evident on radiographs though it may show what?
- internal rotation of the humeral head with a circular appearance (Light bulb sign)
- widened joint space of > 6 mm
- 2 parallel cortical bones lines on the medial aspect of the humeral head (trough line sign)
A HAGL injury is a humeral Avulsion of the Glenohumeral Ligaments, particularly which one?
Inferior glenohumeral ligament
What x-ray view is required for diagnosing a bankart lesion
West Point view
What is a bankart lesion
an avulsion of the labrum off the anteroinferior glenoid rim, generally occurring in the setting of should dislocations . . when this is associated with a glenoid rim fx it is bony bankart
What is Hill-Sachs lesion
defect on the posterolateral head of the humerus caused by chondral impaction on the glenoid
A special Hill-Sach view is used to visualize a hill-sachs lesion . . decribe this view
AP radiograph taken with the shoulder in maximal internal rotation
What classification system can be used on MRI to determine whether surgical intervention would be beneficial in rotator cuff pathology
Goutallier
describe Goutallier classification of rotator cuff pathology
- grade 1: fatty streaks
- Grade 2: fat < muscle
- Grade 3: Fat = muscle
- Grade 4: fat > muscle
What is the rotator interval
- space between the tendons of the supraspinatus and subscapularis
- consists of superior glenohumeral ligament and the caracohumeral ligament
- long head of biceps tendon also contributes to stability to this area
A part in a proximal humerus fx is defined if there is > 1 cm of displacement of 45 degrees of angulation . . what is the exception and why?
- The greater tuberosity, which has a tolerance of 5 mm displacement
- rotator cuff muscles attach there so there may be resultant dysfunction
- the displacement can result in subacromial impingement
In humeral shaft fractures, what are the important acceptable tolerances that will not compromise function or appearance
- 20 degrees AP angulation
- 30 degrees varus-valgus angulation
- 3 cm shortening
In elbow dislocation, the LCL fails first, and then, depending on the degree of injury, the MCL. The capsuloligamentous injury progresses from lateral to medial and is termed what?
the Hori circle
describe the operative approach for Galeazzi fx
- anterior Henry approach
- b/t FCR and BR . . internervous plane (radial and median nerves)
In a distal radius fx, a careful neurovascular assessment should be performed with particular attention to what nerve function
median
The greatest influence on outcome following a distal radius fx is what
carpal alignment
What are the Kanavel cardinal signs which indicate the presence of infectious tenosynovitis of flexor tendon sheaths
- pain with extension of digit
- passive flexion of the digit
- Fusiform (sausage-like) swelling
- Tenderness over the tendon sheath
what is the scaphoid view to catch scaphoid fx
- 30 degrees wrist extension
- 20 degrees ulnar deviation
A scapholunate gap greater than what is a significant finding on x-ray?
What is this called?
- 3 mm
- Terry Thomas sign
