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Orthopaedics > Regional Trauma > Flashcards

Regional Trauma Flashcards

1
Q

Why are femoral shaft fractures dangerous

A

1 litre of blood loss
fat embolism
ARDS

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2
Q

How do you manage a femoral shaft fracture

A

resuscitation
analgesia- femoral nerve block
splint - THOMAS
if unstable - IM nail

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3
Q

How do you manage a distal femur fracture that is extra articular

A

can use thomas splint
if not too distal can IM nail
if very distal - PLATE

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4
Q

How do you manage an intra articular distal femur fracture

A

Anatomical reduction, rigid fixation

PLATE AND SCREWS

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5
Q

What position do distal femur fractures usually adopt

A

flexed - due to pull of gastrocnemius

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6
Q

How do you manage a displaced or angulate phalangeal fracture

A

nerve block and manipulate

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7
Q

how do you manage a stable phalangeal fracture

A

strap to adjacent finger

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8
Q

how do you manage an unstable phalangeal fracture

A

k wires

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9
Q

what is a boxer’s fracture

A

5th metacarpal

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10
Q

how do you manage a boxers fracture and when do they normally occure

A

strap to adjacent finger, use k wires if rotation

usually a punching injury

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11
Q

how do you sustain a scaphoid fracture

A

foosh

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12
Q

how do you manage a scaphoid fracturw

A

if displaced use a compression screw

if undisplaced use a simple plaster cast for 6-12 wks

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13
Q

where is the pain felt in a scaphoid fracture

A

anatomical snuffbox

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14
Q

how long can it take for a scaphoid fracture to show on xray

A

2 weeks

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15
Q

how long can it take for a scaphoid fracture to show on xray

A

2 weeks

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16
Q

What is a bartons fracture

A

intra articular radial fracture

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17
Q

how do you sustain a bartons fracture

A

fall onto an oustretch and pronated wrist

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18
Q

how do you treat a bartons fracture

A

ORIF with plate and screws

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19
Q

What is a smiths fracture

A

extra articular radial fracture with volar diplacement

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20
Q

How do you sustain a smiths fracture

A

FOOSH

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21
Q

how do you treat a smiths

A

ORIF with PLATE and screws

very unstable injuries

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22
Q

What is a colles fracture

A

extra articular radial fracture within 1 inch of the surface with doral displacement

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23
Q

how do you sustain a colles

A

FOOSH

osteoporotic

24
Q

how is a colles treated

A

if minimially displaced - splint and plaster cast

if comminuted - ORIF

25
Q

what complications may occur in a colles

A

median nerve compression ie carpal tunnel

26
Q

what may a late complication of colles be

A

rupture of EPL= dinner fork deformity

27
Q

What is a galeazzi fracture

A

radial fracture with ulnar dislocation at DRUJ

28
Q

how do you treat a galeazzie

A

ORIF radius

29
Q

What is a monteggia

A

ulnar fracture with radial dislocation at the radiocapitellar joint

30
Q

how do you trat monteggia

A

orif of ulna

31
Q

how do you sustain a dual radial and ulanr fracture

A

direct blow or a lot of force

32
Q

how do you treat a dual fracture

A

orif with plates and screws - very unstable

33
Q

what is a night stick fracture and how do you sustain it

A 
ulnar fracture (lone) 
direct blow to arm
34
Q

how do you treat a nightssticj

A

consevative

35
Q

how do you treat an olecranon fracture

A

orif

36
Q

how do you treat a humeral shaft fracture

A

humeral brace

may need IM nails if polytrauma

37
Q

what can result form a humeral shaft fracture

A

radial nerve damage — wrist drop

38
Q

which neck of the humerus i normally fracture

A

surgical

39
Q

what usually causes a humeral neck fracture

A

osteoporotic onto shoulder

FOOSH

40
Q

how is a humeral neck fracture treated

A

sling if minimally displace

if displaced - internal fixation with plates, screws etc

41
Q

what direction is a humeral neck fracture likely to displace

A

medial

pull of pec minor

42
Q

What is a humeral shaft fracture usually caused by

A

RTA

or fall

43
Q

what examination is mandatory in pelvic fractures

A

PR - for sacral tone and to assess for any rectal tears

if rectal tear present then it is an open fracture

44
Q

what investigation is usually needed in acetabuler fracture

A

CT scan - difficult to see on x ray and for surgical planning

young people - ORIF
old people - THR

45
Q

what x rays are taken for scaphoid fractures

A

AP, lateral and 2 obliques = 4 total

46
Q

what is mallet finger

A

avulsion of the extensor tendon from its insterios - results in inability to extend DIP joint

47
Q

treatment of mallet finger

A

splint holding DIP extended for 4 weeks

48
Q

what do you need to watch out for in punching injuries

A

a laceration to the finger caused by tooth - needs to be thoroughly washed out in theatre

49
Q

general management of hip fractures

A

extracapsular - dynamic hipscrew

intracapsular - THR or hemiarthroplasty (for more frail, cognitively impaired patients)

50
Q

proximal tibia plateau fracture

A

surgical management - reduction and rigid fixation with plates and screws

many need a total knee replacementq

51
Q

commonest cause of compartment syndrome

A

tibial shaft fracture

52
Q

tibial shaft fracture

A

intramedullary nail

53
Q

criteria used to decide which ankle injuries need x ray

A

ottowa criteria

54
Q

when is deltoid ligamenet rupture suspeted

A

medial bruising and tenderness

55
Q

treatment of ankle fracture with talar shift

A

anatomic reduction and rigid internal fixation

56
Q

lisfranc fracture

A

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.

57
Q

what is important to remember about lisfranc fractures

A

easily missed as xray can be normal - do a CT

Orthopaedics (25 decks)

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