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Ortho Boards > Trauma > Flashcards

Trauma Flashcards

1
Q

What position has the lowest effect on compartment syndrome of the lower extremity

A

30 deg of ankle plantarflexion

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2
Q

What percentage of femoral neck fractures are missed with ipsilateral shaft fracture

A

5% incidence
30% missed

need to use fine cut CT to find it

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3
Q

What is the most optimal inferior screw placement for femoral neck fractures

A

posterior and adjacent to the femoral neck

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4
Q

Where can you avoid injury to the femoral nerve for retrograde femoral nailing

A

A-P proximal to the LT

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5
Q

Calculation of ISS and MISS

A

square of the largest 3 numbers

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6
Q

compare medial to lateral subtalar dislocations

A

medial are more common
lateral are more likely to be open with fractures
medial are more likley to be stable

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7
Q

predictor of sacral fracture nonunion

A

vertical fracture pattern

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8
Q

what factor most likley increases mortality in head injury patients

A

intra-operative hypotension

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9
Q

risk of infection in calcaneus fractures

A

smoking
open
diabetes

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10
Q

what parameter in pilon fractures determines poor outcome and return to work

A

lower level of education

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11
Q

gull sign on obturator oblique

A

posterior wall

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12
Q

spur sign on obturator oblique

A

ABC

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13
Q

imaging require for percutaenous column screws

A

obturator oblique - joint penetration
inlet iliac oblique - position of screw in pubic ramus
inlet obturator oblique - position of screw in iliac table

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14
Q

how much saline should you inject to diagnose traumatic arthrotomy of the knee

A

155 mL

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15
Q

indications of pre-ganglionic injury

A

loss of paraspinal muscles on EMG
horners
positive histamine test
medially winged scapula

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16
Q

benefits of blocking screws

A

obtain and maintain reduction
increase construct stiffness
neutralize translation forces

17
Q

appropriate tibial alignment

A

50% cortical apposition

18
Q

incidence of vascular injury in knee dislocation

A

40%

19
Q

leading cause of death in pelvic ring fracture

A

hemmorhage overall

head injury in lateral compression

20
Q

factors associated with increased mortality in pelvic ring fractures

A

systolic BP 60 years
increased Injury Severity Score (ISS) or Revised Trauma Score (RTS)
need for transfusion > 4 units

21
Q

risk of anterior S1 plating

A

L4/5 injury

22
Q

fresh water wounds

A

cipro

23
Q

salt water wounds

A

doxycycline or ceftazidime

24
Q

normal syndesmosis widening

A 
decreased tibiofibular overlap 
     normal >6 mm on AP view
     normal >1 mm on mortise view
increased medial clear space 
      normal less than or equal to 4 mm
increased tibiofibular clear space 
      normal
25
Q

most important factor with outcome following amputation or reconstruction

A

ability to return to work

no difference in treatment

26
Q

factors associated with wound healing

A 
albumin > 3.0 g/dL 
ischemic index > .5
transcutaneous oxygen tension > 30 mm Hg 
toe pressure > 40 mm Hg 
ankle-brachial index (ABI) > 0.45
total lymphocyte count (TLC) > 1500/mm3
27
Q

complications of scapulothoracic dissociation

A 
flail extremity (50%) - requires ampuation
early amputation (20%)
death (10%)
28
Q

air bag decreases the rate of

A

closed head injuries
facial fractures
thoracoabdominal injuries
need for extraction

29
Q

indications of adequate resusitation

A

MAP > 60
HR 7.2
base deficit - normal -2 to +2
pusle pressure > 15

30
Q

parameters to consider DCO

A 
ISS >40 (without thoracic trauma)
ISS >20 with thoracic trauma
multiple injuries with severe pelvic/abdominal trauma and hemorrhagic shock
bilateral femoral fractures
pulmonary contusion noted on radiographs
hypothermia
31
Q

when do fix DCO fractures

A

7-10 days for pelvic fractures
within 3 weeks for femur fractures
7-10 days for tibia fractures

32
Q

predictors of good outcomes in acetabular fractures

A 
increasing patient age
time from injury to surgery (>3 weeks)
intraoperative complications
femoral head bone or cartilage injury
fracture reduction > 1-2mm
33
Q

risk factors for spousal abuse

A 
younger age
shorter length of relationship
emotional abuse
psychological abuse, sexual abuse
drug dependency
alcohol dependency
34
Q

the medial femoral circumflex is

A

medial to glut maximus

Ortho Boards (9 decks)

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