Trauma Flashcards
when is an open reduction of a dislocation indicated
if soft tissue in way or late presentation
what is necessary following a closed joint reduction
assess neurovascular status and XR to confirm reduction
what are the common causes of joint replacements failing
loosening in high inflam/stress or pseduotumour
what is the infection risk in joint replacements
1-2%
what is the management of fulminant infection of a joint replacement diagnosed <3wk after surgery
washout & debride, 6wk IV ABx, salvage
what process is occurring in fulminant infections of joint replacements diagnosed >3wk after surgery
biofilm
what is the management of fulminant infection of a joint replacement diagnosed >3wk after surgery
no joint 6wk + ABx, revision;
what is a resection arthroplasty
bone/cartilage removal on 1/both joint sides
give an example of a resection arthroplasty and when its indicated
Keller’s procedure; hallux valgus
what is arthrodesis
artificial induction of joint ossification between 2 bones
give an example of an indication of osteotomy
redistributing load for knee OA in a young patient
what are the 3 grades of ligament rupture
1 sprain
2 partial tear
3 complete tear
what is the management of a sprain
RICE, early ROM
what cancers commonly metastasise to bone
lung, kidney, breast, prostate
give examples of surgeries which use primary bone healing
plate/screws
give examples of surgeries which use secondary bone healing
ex-fix
what is the management of intra-articular fractures and why
IM nail since > post traumatic OA risk
what is enthesopathy
tendon origin or the insertion into bone inflam
what is tenosynovitis
tendon sheath inflam
what is tendonitis
tendon inflam
what is tendinopathy
disease of a tendon
what is tendonosis
chronic tendon injury & tendon ECM damage
what is a sprain
some ligament/tendon fibres tear on rapid resisted contraction
what is the management of an achilles tear
conservative
what is the management of a patellar or quadriceps tendon tear
surgical repair
what is the management of a meniscal tear
arthroscopic removal if pain doesn’t settle or if locking/catching
what is the management of a rotator cuff tear
conservative
what is the management of a acetabulum/glenoid tear
resect or repair
what is the management of a biceps tendon tear
conservative
what is the management of a tibialis posterior tear
tendon transfer
what is the management of extensor pollicis longus tendon tear
tendon transfer
what technique can be used for limb length discrepancies
external fixation
what drugs should be given for open fractures
anti-tetanus thing and prophylactic antibiotics
what terms are used to describe the alignment of a fracture
displaced and angulated
how do you describe displacement of a fracture
according to distal fragment
what a tomogram
ct
which suspected fractures require ct
vertebrae, pelvis, calcaneus, glenoid
what suspected fractures require mri
hip and scaphoid
what suspected fractures requires more than 2 xr views
cervical spine: AP, lateral, odontoid peg
scaphoid: AP, lateral, oblique X2
what part of long bones can be a fracture mimic
physis
management of diaphyseal fracture
immobilize above & below joint
management of metaphyseal fracture
immobilize adjacent joint
what kills you in the golden hour after major trauma
airway compromise, head/chest injury, organ rupture, blood loss
what are the early local fracture complications
compartment synd, vascular injury, ischaemia, nerve injury, skin necrosis
what are the early systemic fracture complications
hypovolaemia, fat embolism, ARDS, SIRS, MODS, acute renal failure, death
what are the late local fracture complications
LOF, OA, nonunion, CRPS, AVN, Volkmann’s ischaemic contracture, malunion, infection, DVT
what are the late systemic fracture complications
PE
management of DVT
LMWH
what age are avulsion fractures commonest
children
what is an avulsion fracture
tendon/ligament rips off fragment
what are avulsion fracture mimics
accessory ossification, completely corticated bone sesamoid, old non-united #
what is a transverse fracture
horizontal through long bone
injury mechanism causing spiral fractures
torsion/rotation
management of spiral fracture
screw
injury mechanism of oblique fractures
fall from height/deceleration
management of oblique fracture
screw
what is a comminuted fracture
3+ fragments
what is the mechanism of comminuted fractures
high energy or poor bone
risk in comminuted fractures
compartment synd
management of comminuted fractures
IM nail
what is a segmental fracture
2 separate fractures of one bone
management of segmental fracture
stabilisation by long rod/plate
what is an impaction fracture
fragment driven in another
give 4 examples of bony rigns
spinal canal, pelvis, forearm, leg
what is a greenstick fracture
incomplete # of children’s softer bone, opposite cortex ruptured
what is the management of a greenstick fracture
POP
what is a buckle fracture
bend of child’s soft bone, opposite cortex intact
what is the management of a buckle fracture
3wk splint
what is another name for a buckle fracture
torus fracture
what bone are buckle fractures often of
radius
what is a salter harris fracture and what age do they occur
epiphyseal growth plate, children
what is a type I salter harris fracture
complete physeal #+- displacement
what is a type II salter harris fracture
physeal# though metaphysis, producing metaphysis chip
what is a type III salter harris fracture
physeal# though epiphysis
what is a type IV salter harris fracture
physeal+ epiphyseal+ metaphyseal
what is a type V salter harris fracture
growth plate compression#
what is the commonest salter harris fracture
II
which salter harris fractures are intra-articular
III and IV
