Regional Trauma Flashcards
Why are femoral shaft fractures dangerous
1 litre of blood loss
fat embolism
ARDS
How do you manage a femoral shaft fracture
resuscitation
analgesia- femoral nerve block
splint - THOMAS
if unstable - IM nail
How do you manage a distal femur fracture that is extra articular
can use thomas splint
if not too distal can IM nail
if very distal - PLATE
How do you manage an intra articular distal femur fracture
Anatomical reduction, rigid fixation
PLATE AND SCREWS
What position do distal femur fractures usually adopt
flexed - due to pull of gastrocnemius
How do you manage a displaced or angulate phalangeal fracture
nerve block and manipulate
how do you manage a stable phalangeal fracture
strap to adjacent finger
how do you manage an unstable phalangeal fracture
k wires
what is a boxer’s fracture
5th metacarpal
how do you manage a boxers fracture and when do they normally occure
strap to adjacent finger, use k wires if rotation
usually a punching injury
how do you sustain a scaphoid fracture
foosh
how do you manage a scaphoid fracturw
if displaced use a compression screw
if undisplaced use a simple plaster cast for 6-12 wks
where is the pain felt in a scaphoid fracture
anatomical snuffbox
how long can it take for a scaphoid fracture to show on xray
2 weeks
how long can it take for a scaphoid fracture to show on xray
2 weeks
What is a bartons fracture
intra articular radial fracture
how do you sustain a bartons fracture
fall onto an oustretch and pronated wrist
how do you treat a bartons fracture
ORIF with plate and screws
What is a smiths fracture
extra articular radial fracture with volar diplacement
How do you sustain a smiths fracture
FOOSH
how do you treat a smiths
ORIF with PLATE and screws
very unstable injuries
What is a colles fracture
extra articular radial fracture within 1 inch of the surface with doral displacement
how do you sustain a colles
FOOSH
osteoporotic
how is a colles treated
if minimially displaced - splint and plaster cast
if comminuted - ORIF
what complications may occur in a colles
median nerve compression ie carpal tunnel
what may a late complication of colles be
rupture of EPL= dinner fork deformity
What is a galeazzi fracture
radial fracture with ulnar dislocation at DRUJ
how do you treat a galeazzie
ORIF radius
What is a monteggia
ulnar fracture with radial dislocation at the radiocapitellar joint
how do you trat monteggia
orif of ulna
how do you sustain a dual radial and ulanr fracture
direct blow or a lot of force
how do you treat a dual fracture
orif with plates and screws - very unstable
what is a night stick fracture and how do you sustain it
ulnar fracture (lone) direct blow to arm
how do you treat a nightssticj
consevative
how do you treat an olecranon fracture
orif
how do you treat a humeral shaft fracture
humeral brace
may need IM nails if polytrauma
what can result form a humeral shaft fracture
radial nerve damage — wrist drop
which neck of the humerus i normally fracture
surgical
what usually causes a humeral neck fracture
osteoporotic onto shoulder
FOOSH
how is a humeral neck fracture treated
sling if minimally displace
if displaced - internal fixation with plates, screws etc
what direction is a humeral neck fracture likely to displace
medial
pull of pec minor
What is a humeral shaft fracture usually caused by
RTA
or fall
what examination is mandatory in pelvic fractures
PR - for sacral tone and to assess for any rectal tears
if rectal tear present then it is an open fracture
what investigation is usually needed in acetabuler fracture
CT scan - difficult to see on x ray and for surgical planning
young people - ORIF
old people - THR
what x rays are taken for scaphoid fractures
AP, lateral and 2 obliques = 4 total
what is mallet finger
avulsion of the extensor tendon from its insterios - results in inability to extend DIP joint
treatment of mallet finger
splint holding DIP extended for 4 weeks
what do you need to watch out for in punching injuries
a laceration to the finger caused by tooth - needs to be thoroughly washed out in theatre
general management of hip fractures
extracapsular - dynamic hipscrew
intracapsular - THR or hemiarthroplasty (for more frail, cognitively impaired patients)
proximal tibia plateau fracture
surgical management - reduction and rigid fixation with plates and screws
many need a total knee replacementq
commonest cause of compartment syndrome
tibial shaft fracture
tibial shaft fracture
intramedullary nail
criteria used to decide which ankle injuries need x ray
ottowa criteria
when is deltoid ligamenet rupture suspeted
medial bruising and tenderness
treatment of ankle fracture with talar shift
anatomic reduction and rigid internal fixation
lisfranc fracture
fracture of the base of the 2nd metatarsal is associated with dislocation of the base of the 2nd metatarsal with or without dislocation of the other metatarsals at the tarso‐metatarsal joints.
what is important to remember about lisfranc fractures
easily missed as xray can be normal - do a CT
