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PHM BSc - Trauma Science > Sports Injuries > Flashcards

Sports Injuries Flashcards

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1
Q

Where do clavicular fractures normally occur

A

middle 1/3 of the clavicle

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2
Q

How does the arm of someone with a clavicle fracture look and why

A

proximal to fracture: lifts due to SCM attachment

distal to fracture: drops due to weight

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3
Q

What are the complications associated with a clavicle fracture

A

subclavian artery and vein
brachial plexus damage
pneumothorax
skin tenting can break down and it can become an open fracture

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4
Q

how is a clavicle fracture managed

A

broad arm sling

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5
Q

How does an acromio-clavicular dislocation present

A

shoulder is squared off

the squaring occurs more proximal than would occur with a shoulder dislocation

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6
Q

Which way does the shoulder most commonly dislocate and why

A

anteriorly because this is where the rotator cuff is at it’s weakest

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7
Q

how does an anterior shoulder dislocation appear on x-ray

A

inferior, medial and overlying glenoid

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8
Q

What is a complication of shoulder dislocations

A

axillary nerve damage

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9
Q

How is a shoulder dislocation managed

A

relocate with the cunningham technique - massage trapezius and deltoid to relax them and the humeral head should fall back into place.
Entonox
traction and counter traction
broad arm sling

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10
Q

What is luxation erecta and how is it managed prehospitally

A

bilateral inferior dislocation of the shoulders

package them with their arms above their heads as impossible to reduce prehospitally

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11
Q

what can complicate a proximal humerus fracture

A

AVN due to damage to anterior humeral circumflex

axillary nerve

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12
Q

where does the proximal humerus most commonly fracture

A

surgical neck

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13
Q

how is a proximal humerus fracture managed

A

cuff and collar

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14
Q

what nerve can be damaged in humeral shaft fractures

A

radial nerve

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15
Q

what structures can be damaged in distal humerus fractures

A

brachial artery

median and radial nerve

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16
Q

why is ketamine not ideal in dislocations

A

it is a sympathomimetic so tightens everything up preventing relocation

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17
Q

which way does the elbow most often dislocate

A

postero-lateral (humerus sits anterior to the olecranon)

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18
Q

what structures can be damaged in an elbow dislocation

A

Ulnar nerve is stretched

brachial artery and radial nerve are rarely damaged too

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19
Q

how should an elbow dislocation be managed

A

relocate by pushing your thumbs against the olecranon

benecast

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20
Q

what nerve can be damaged in distal forearm fractuers

A

Median

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21
Q

compare a colles and smiths fracture

A

colles - dorsal displacement of the distal fragment

smiths - volar displacement of the distal fragment

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22
Q

What can cause musculocutaneous nerve damage and what does this result in

A

stab wound to axilla
loss of sensation to lateral forearm
weak elbow flexion
loss of biceps reflex

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23
Q

What can cause axillary nerve damage and what does this result in

A

anterior shoulder dislocation
proximal humerus fractures (surgical neck)
loss of sensation in regimental badge area
weakened abduction from 15-90 degrees

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24
Q

What can cause radial nerve damage and what does this result in

A

humeral shaft fracture
loss of sensation to posterior arm, forearm, hand and digits laterally (i.e. thumb)
weak elbow, wrist and MCPJ extension
loss of triceps reflex

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25
Q

What can cause median nerve damage and what does this result in

A 
distal humerus fracture
loss of sensation to palm and digits laterally (i.e. thumb)
weak wrist and digit flexion
weak wrist abduction
weak thumb opposition
26
Q

What can cause ulnar nerve damage and what does this result in

A

elbow dislocation it is commonly stretched
distal humerus fractures
loss of sensation to ventral and dorsal palm and digits medially (i.e. little finger)
weak wrist adduction
weak finger ab/adduction and other intrinsic hand movements

27
Q

how does traction and countertraction work in relocating bones?

A

fatigues the muscles so that they relax and the bones can fall back into place

28
Q

common injury mechanism causing hip dislocations

A

dashboard injury

direct blow to femoral head

29
Q

which way does the hip commonly dislocate

A

posterior

30
Q

how does a dislocated hip present and why

A

shortened and internally rotated

because the anterior muscles become taught

31
Q

how does a dislocated hip appear on x-ray

A 
loss of shentons line
loss of lesser trochanter (because it's internally rotated)
appears smaller (moved posteriorly)
32
Q

what can often be damaged in hip dislocations

A

sciatic nerve

33
Q

how is a dislocated hip reduced

A

Allis manoeuvre

34
Q

what causes an anterior hip dislocation and what structures are at risk of damage

A

direct blow to the femoral head

femoral nerve, artery and vein can be damaged

35
Q

how does a hip fracture present and why

A

shortened and externally rotated

because of unopposed iliopsoas

36
Q

what structure is at risk of damage in a fractured NOF

A

medial circumflex artery leading to AVN

37
Q

describe how hip fractures are categorised anatomically

A

intracapsular: subcapital or basicervical
extracapsular: intertrochanteric or subtrochanteric

38
Q

how is a midshaft femur fracture managed prehospitally

A

KTD

39
Q

what complications can occur as a result of a distal femur fracture

A

fat emboli can lead to ARDS especially in young people
damage to popliteal vessels
major haemorrhage

40
Q

which way does the knee commonly dislocate

A

posterior

41
Q

what can cause an anterior knee dislocation

A

hyperflexion of the knee

42
Q

what structures are at risk when a knee dislocates

A

popliteal vessels - you need to CTA them
common fibular nerve
PCL (especially in anterior dislocation)

43
Q

which way does the patella commonly dislocate

A

laterally

44
Q

how should a patella dislocation be managed

A

place thumbs on the lateral patella and push medially whilst hyperextending the knee

45
Q

what is a lisfranc injury

A

disruption of the medial cuneiform and 2nd metatarsal which is dorsally displaced

46
Q

what causes a lisfranc injury

A

axial load on a hyper-plantarflexed forefoot

47
Q

what causes a calcaneous fracture

A

jump/fall from height onto the feet - axial load

48
Q

how does a person with a pelvic fracture present

A

groin pain
considerable bruising
externally rotated legs

49
Q

where does the bleeding in a pelvic fracture come from and where does it pool

A

90% of the time it comes from the venous plexus (located near sacroiliac joint so at risk of damage)
This bleeding is retroperitoneal
Bleeding can also come from the cancellous bone

50
Q

why is the venous plexus at risk in pelvic fractures

A

it is thin walled

located near the sacroiliac joint which is often disrupted in pelvic fractures

51
Q

Describe which structures are damaged in a AP pelvic fracture

A

pubic bones separate
sacroiliac joint separates
sacrospinous and sacrotuberous ligaments

52
Q

what vessel is at risk in an AP pelvic fracture

A

superior gluteal artery

53
Q

why are AP pelvic fractures more dangerous than lateral

A

because of the external rotation they cause the pelvic volume to increase therefore there is more space for blood to be lost into

54
Q

describe the structures damaged in a LC pelvic fracture

A

pubic rami
sacral alar
iliac wing

55
Q

what vessels are at risk in an LC pelvic fracture

A

internal pudendal artery

obturator artery

56
Q

describe a VS pelvic fracture

A

vertical shift of the hemipelvis

57
Q

when is the femoral nerve commonly damaged and what deficit results

A

anterior hip dislocations
weak hip flexion and knee extension
loss of sensation to anterior thigh and medial leg

58
Q

when is the sciatic nerve commonly damaged and what deficit results

A

posterior hip dislocation, pelvic fractures, IM injection into gluteal region, disc prolapse
weak hip extension
loss of sensation to lateral leg

59
Q

when is the common fibular nerve commonly damaged and what deficit results

A

tight cast
neck of fibular fracture
weak ankle dorsiflexion

60
Q

when is the obturator nerve commonly damaged

A

anterior hip dislocation

61
Q

How is a suspected pelvic fracture managed

A

pelvic binder centred over the greater trochanters

PHM BSc - Trauma Science (15 decks)

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