Trauma Flashcards
0
Q
Where is the M/C location for a type 2 Salter Harris Fx (according to Yochum)?
A
Distal radius (50%)
1
Q
What is a hickory stick fracture?
A
Greenstick fx
2
Q
What is the M/C location for a type 3 Salter Harris Fx (according to Yochum)?
A
Distal tibia
3
Q
What is the M/C location for a type 4 Salter Harris Fx (according to Yochum)?
A
Distal humerus lateral condyle –> pediatric
Distal tibia –> above 10yrs
4
Q
What is the M/C location for a type 5 Salter Harris Fx (according to Yochum)?
A
Distal femur & distal tibia
5
Q
What is the M/C type of Salter Harris Fx?
A
Type 2
6
Q
What are the 3 stages of fracture repair?
A
- Circulatory (Inflammatory) Phase
- Reparative (Metabolic) Phase
- Remodeling (Mechanical) Phase
7
Q
What are some immediate fracture complications?
A
a. vascular injury
b. compartment syndrome
c. gas gangrene
d. fat embolism
e. thromboembolism
8
Q
What are some intermediate fracture complications?
A
a. osteomyelitis
b. hardware failure
c. reflex sympathetic dystrophy syndrome
d. refracture
e. myositis ossificans
f. delayed union
9
Q
What are some delayed fracture complications?
A
a. osteonecrosis
b. degenerative joint disease
c. lead arthropathy/toxity
d. osteoporosis
e. malunion
f. nonunion
g. ABC
10
Q
What % of skull fractures are seen on plain films?
A
Less than 10%.
11
Q
What are some complications of skull fractures?
A
a. Leptomeningeal cyst
b. Subdural & extradural hematoma
c. pneumocephalus – air from sinus or mastoid air cell
12
Q
What is the M/C type of skull fracture and where does it M/C occur?
A
Linear (80%) at temporal & parietal bone
13
Q
What should you look for with basal skull fractures?
A
Air/fluid level or opacification of sphenoid sinus
14
Q
What is the M/C facial bone fracture?
A
Tripod – involves 3 limbs of zygoma: arch, orbital process and maxillary process
15
Q
What is the slowest healing bone in the body?
A
Mandible
16
Q
What % of cervical spine injuries involve neurologic damage?
A
40%
17
Q
What is the M/C atlas fracture and what is the mechanism of injury?
A
Posterior arch fracture (bilateral) – severe hypertension
18
Q
What is the mechanism of injury for a Jefferson fx?
A
Compression
19
Q
The lateral masses should not offset the articular process of the axis by this measurement:
A
3mm
20
Q
Which type of dens fracture is common and heals easily?
A
Type 3 – heals quickly b/c blood supply to dens is not compromised.
21
Q
What sign is seen in the sagittal plane when there is a C2 body fracture?
A
Fat C2 sign
22
Q
By what age does the dentocentral synchondrosis fuse?
A
7yrs
These should not be confused for dens fractures.
23
Q
What is the mechanism of injury for a teardrop fracture?
A
Acute hyperextension or hyperflexion
24
According to Yochum, teardrop fractures are stable or unstable?
Unstable -- ALL torn & disc avulsed from endplates
25
Teardrop fractures can be associated with which life-threatening syndrome?
Anterior cervical cord syndrome -- immediate, complete paralysis
26
What are the synonyms for clay shoveler's fracture?
a. coal miner's fracture
b. root-puller's fracture
c. Smith fracture in a child ???
27
What is the mechanism of injury for a bilateral interfacetal dislocation and where is it most common?
Severe hyperflexion
M/C C4-C7
28
What are some radiographic signs of a bilateral interfacetal dislocation?
a. naked facet
b. divergent SPs
c. dislocated body displaced anteriorly
d. acute kyphosis
29
What is the mechanism of injury for a unilateral interfacetal dislocation?
Flexion/rotation force
30
What % anterior disc height loss is considered significant in an anterior compression fracture?
30%
31
What are the M/C locations for a posterior limbus bone?
L4 and L5
32
What are some mechanisms for developing a posterior lumbus bone?
auto accident, weight lifting or gymnastics
33
What is delayed posttraumatic vertebral collapse called?
Kummel's disease
34
What is the 1st and 2nd M/C lumbar spine fracture?
```
1st = compression fx
2nd = transverse process fx
```
35
What is the M/C location for a lumbar transverse process fx?
L2 and L3
36
What is LOBS?
Lumbar ossified bridging syndrome --> myositis ossificans within the hemorrhage from the transverse process fx
37
What is Wilkinson's syndrome?
Stress hypertrophy of contralateral pedicle in the presence of a unilateral spondylolysis
38
What is suicide jumper's fx?
Horizontal upper sacral fx from a fall from great height.
39
What is the M/C pelvic fx?
Malgaigne fx (33%)
40
Vertical sacral fx are associated with pelvic organ damage what % of time?
50%
41
Type III has a predilection for which pop'n?
Degenerative -- female & black
42
According to Yochum, what is the M/C acetabular fx?
Central acetabular fx
43
What is a explosion fx?
Central acetabular fx
44
What is the M/C unstable pelvic fracture
Straddle fx
45
Symphysis pubis avulsion is M/C seen in which pop'n?
Soccer players d/t adductor mm
46
Which other associated injuries are seen with straddle fracture?
Bladder/urethra damage (20%)
47
What % of SCFE is bilateral and who does it M/C occur in?
20-30% M/C in females
48
What is Herndon's hump?
medial buttressing or lateral buttressing on femoral neck (associated with SCFE?)
49
What is the named radiographic sign of seeing the femoral metaphysis lateral to the posterior acetabular margin?
Capener's sign
50
List two causes for a pistol-grip deformity.
a) FAI
| b) SCFE
51
SCFE is associated with which other conditions?
- renal osteodystrophy
- rickets
- radiotherapy
- adiposogenital dystrophy = Frolich's syndrome (obesity w/ gonadal hypodevelopment)
52
Tibial plateau fx are M/C on which side?
Lateral (80%)
53
What is trampoline fx?
Fx through proximal tibial metaphysis (commonly in children)
54
Segond fx is almost always associated with which other condition?
ACL tears
55
Proximal tibiofibular dislocations are commonly seen in which pop'n?
Parachutists
56
Patellar dislocations M/C are seen in which direction?
a. Superolateral
b. Inferolateral
c. Superomedial
d. Inferomedial
Superolateral
57
Where is the 2nd M/C location for an FBI?
Shoulder
58
What are the 3 types of Weber's classification for ankle fractures?
Type A = fibula fractured below tibiotalar joint
Type B = fibula fractured at level of tibiotalar joint
Type C = fibula fractured above tibiotalar
59
a) What is the maximum allowable "tilt" difference on stress ankle films from left to right?
b) What is the maximum allowable difference in joint space from left to right?
c) What is the maximum allowable "tilt" difference from left to right on neural position?
a) 10 degrees
b) 3mm
c) 6 degrees
60
What is the McKenzie's sign?
Soft tissue swelling adjacent to oblique radiolucency.
61
What is a Cotton's fracture?
Trimalleolar fx
62
What is a Pott's fx?
- Fibular fx 6-7cm above lateral malleolus
- Tibiofibular ligaments ruptured
- Deltoid ligament tear???
63
What is a Dupuytren's fx?
- Distal fibular fracture
- Ruptured tibiofibular ligament w/ diastasis
- Lateral dislocation of talus
(Foot is displaced upward & outward, tibia is displaced medially.)
64
What is a Maisonneuve's fx? What is the mechanism of injury?
- Torn inferior tibiofibular syndesmosis
- Proximal fibular fx
Forceful inversion & external rotation of ankle
65
What is a Tillaux's fx?
- Medial malleolus fx
- Distal tibiofibular diastasis
- Tibial anterior tubercle avulsion
- Distal fibular fx
66
What is a toddler's fx?
Tibial spiral fx (commonly seen in children 3yrs and younger)
67
What direction is M/C for an ankle dislocation?
Posterior (caused by blow to posterior tibia)
68
What is the M/C tarsal bone to fracture? What is the 2nd M/C tarsal bone to fracture?
```
1st = calcaneus
2nd = talus
```
69
What is the M/C type of talus fracture? What is the 2nd M/C talus fracture?
```
M/C = talar dome fx
2nd = vertical fracture through talar neck (Aviator's fx)
```
70
Which ribs are most likely to be affected in a cough fx?
Anterior 6th & 7th ribs
71
What is the M/C fractured bone in a child?
clavicle
72
What is the M/C fractured bone during birthing for the baby?
Clavicle
73
Where is the M/C location for a clavicle fx?
Middle > lateral > medial
74
What are the 4 subtypes of anterior glenohumeral joint dislocation and which one is M/C?
a) Subcoracoid M/C
b) Subglenoid
c) Subclavicular
d) Intrathoracic
75
What are the causes for a posterior GH dislocation?
- epileptic convulsions
- electric shocks
- direct trauma
76
What are the radiographic signs associated with a posterior GH dislocation?
- Rim sign = jt space > 6mm
- Trough sign = double articular surface line on humerus
- Vacant glenoid = no close anterior joint margin contact
- Tennis racquet appearance = cystic-looking humeral head
- Diminished/absent overlap of glenoid fossa and humeral head
- Humeral head looks identical in ER & IR
77
What is another name of inferior GH dislocations?
Luxatio erecta
78
What is the measurement of the acromiohumeral space indicating rotator cuff tear?
<7mm
79
The coracoclavicular distance should be within how many mm compared to the contralateral side to be considered normal?
Within 5mm
80
The AC joint space should be within how many mm compared to the contralateral side to be considered normal?
Within 2-3mm
81
What is the Neer classification?
```
For proximal humeral fx.
One part = one fx line (M/C 80%)
Two part = two fx lines
Three part = three fx lines
Four part = four fx lines
```
82
What % of adult fx in the elbow involves the radial head?
50%
83
What % of elbow fx in the children involves the supracondylar region?
60%
84
What is a Kocher's fx?
Osteochondral fx of the capitellar surface.
85
What is a sideswipe fx?
Comminuted ulnar and radial fx (occurs when elbow protrudes from the car)
86
What are 2 common mechanisms of injury for the coronoid process?
a) avulsion by brachialis mm
| b) in association with posterior elbow dislocation
87
What is a chisel fx?
Incomplete radial head fx
88
What % of elbow fx in children will have a visible posterior fat pad?
90%
89
What is an Essex-Lopresti Fx?
- comminuted radial head fx
| - distal radioulnar dislocation
90
What is an aka for Galeazzi fx?
Piedmont Fx OR reversed Monteggia fx
91
What are the top 3 M/C dislocation locations in an adult?
```
1st = shoulder
2nd = IP joints of fingers
3rd = elbow
```
92
What is the M/C dislocation in a child?
Elbow
93
What is Little Leaguer's elbow?
Medial epicondyle avulsion caused by stress on immature, ununited apophysis.
94
What are the aka for nursemaid elbow?
- Pulled elbow
- Toddler elbow
- Safeway elbow
95
The dinner fork deformity is associated with which fx?
Colles' Fx
96
How often is the ulnar styloid fractured in a Colles' fx?
60%
97
What is a Barton's fx and what is an aka for it?
Proximal dislocation of carpus w/ posterior rim fx of radius joint surface.
aka. Rim fx
98
What is a Chauffeur's fx and what are its aka?
Radial styloid process fx.
Aka. backfire fx, Hutchinson's fx
99
What is a Moore's fx?
Ulnar styloid process fx w/ distal ulna dislocation. Associated with Colles' fx.
100
What is the childhood version of a Colles' fx and what is its MOI?
Slipped radial epiphysis fx -- forceful hyperextension injury
101
What is the M/C site for an occult fx?
Scaphoid (70% waist)
102
What is the incidence of AVN in a scaphoid fx? What is the incidence of nonunion in a scaphoid fx?
AVN -- 15%
| Nonunion -- 30%
103
What is the M/C carpal instability?
Scapholunate dissociation
105
What is an eponym for triquetrum fracture?
Fischer's fx
106
What is the difference btwn lunate and perilunate dislocation?
Lunate = articulation with capitate disrupted; articulation w/ radius intact
Perilunate = lunate remains in normal apposition to radius
107
Perilunate dislocations can be associated with which other injury? What is the name of this conjoined injury?
Trans-scaphoid perilunate dislocation.
Fracture of the scaphoid waist --> proximal scaphoid fragment in normal position with lunate; distal fragment dislocates dorsally with rest of carpals
108
What is another name for trans-scaphoid perilunate dislocation?
deQuervain's fracture dislocation
109
What is the M/C fracture site in the entire skeleton?
phalanges
110
What is a Bennett's fx?
-Intra-articular fx through base of 1st metacarpal
111
What is Rolando's fx?
A comminuted Bennett's fx
112
What is turret exostosis?
- Ossified subperiosteal hemorrhage
| - M/C ulnar-dorsal base of proximal or middle phalanx
113
What is gamekeeper's thumb?
Tear of UCL of the 1st MCP (may or may not have an associated avulsion fx)
114
What are the synonyms for non-accidental trauma?
- Battered child syndrome
- Shaken infant syndrome
- Infant abuse syndrome
115
What are the M/C locations for post-traumatic myositis ossificans?
- brachialis anterior
- quadriceps femoris
- thigh adductors
- MCL knee (Pellegrini-Stieda)
- coracoclavicular ligament
- deltoid muscle
116
What is Prussian's disease?
Ossification in adductor magnus found in riders.
117
What is LOBS and what does it stand for?
Lumbar ossified bridge syndrome = ossified hematoma in psoas that may form union btwn lumbar TPs
118
What conditions does the Achilles' tendon ossify?
FORWARD G:
```
Fluorosis
Ochronosis
Renal failure
Wilson's disease
AS
Reiter's syndrome
DISH
Gout
```
119
What is the M/C skeletal fungal infection worldwide?
Maduromycosis
| USA = monosporium apiospermum; elsewhere = Nocardia madurae
120
Actinomycosis has a high incidence to infect which areas?
face and neck
121
Coccidioidomycosis has a predilection for which skeletal areas?
Bony prominences (eg. trochanters, malleoli, calcaneus, olecranon)
122
Maduromycosis M/C affects which body region?
Tarsometatarsal
123
How is coccidioidomycosis organism acquired?
The fungus spores in dust are inhaled.
124
What is the maximum allowable distance of the scapholunate space?
4mm
