Trauma Imaging

Question 1

What is a flail segment?

Answer 1

Flail chest or flail thoracic segment occurs when three or more contiguous ribs are fractured in two or more places

Question 2

What is the most commonly injured solid organ in the body?

Answer 2

the spleen

Question 3

How can you treat splenic laceration without doing splenectomy?

Answer 3

can do embolisation of the splenic artery due to the fact that the spleen has a dual blood supply coming from short gastric arteries too

Question 4

What is the second most commonly injured solid organ in trauma?

Answer 4

the liver

Question 5

What is the main treatment for liver trauma?

Answer 5

bed rest

Question 6

What is third most injured solid organ in trauma?

Answer 6

the kidney

Question 7

Why are you more worried about kidney trauma vs liver and spleen?

Answer 7

kidney has end organ blood supply so much more worried about infarction

Question 8

Name 5 types of fracture and the force that causes them?

Answer 8

transverse (bending force)
oblique (shearing force)
spiral (torsional force)
comminuted (high energy fracture)
segmental (break in two places)

Question 9

What is the fat pad sign?

Answer 9

on elbow XR should only see an anterior fat pad normally but in joint effusion there will also be a posterior one, this could be a sign that there is a fracture

Question 10

What is a Colles fracture?

Answer 10

this is an extra articular fracture of the distal radius with dorsal displacement or angulation

Question 11

Colles fractures mechanism?

Answer 11

FOOSH injuries more commonly in those over 60

Question 12

Characteristic of colles fracture?

Answer 12

dinner fork deformity

Question 13

Treatment of colles fracture?

Answer 13

depends on the level of displacement can be done with just a sling

Question 14

What is a smiths fracture?

Answer 14

extra articular fracture of the distal radius with volar displacement or angulation

Question 15

Mechanism of smiths fracture?

Answer 15

fall onto the back of a flexed wrist

Question 16

Treatment of smiths fracture?

Answer 16

all need ORIF as highly unstable

Question 17

Mechanism of scaphoid fracture?

Answer 17

FOOSH injury

Question 18

Presentation of a scaphoid fracture?

Answer 18

pain and tenderness in the anatomical snuff box and pain on compressing the thumb metacarpal

Question 19

Describe visualising scaphoid fractures on x ray and treatment?

Answer 19

scaphoid fractures may not be visible on x ray until 2 weeks after fracture so if it is suspected it is important to splint it anyway because of the risk of non-union, AVN and secondary OA.

Question 20

Supracondylar fracture of the elbow is relatively common in _________

Answer 20

growing children

Question 21

Mechanism of supracondylar fractures of the elbow?

Answer 21

extension type fractures are more common where there is a fall onto an outstretched hand

Question 22

Potential complications of supracondylar fracture of the elbow in children?

Answer 22

pressure on the brachial artery and the anterior interosseous branch of the median nerve

Question 23

Describe intracapsular femoral fracture and treatment?

Answer 23

in these fractures the arterial supply of the femoral head can be disrupted and there is risk of AVN and non-union of the fracture
treatment: need to replace the femoral head, total hip replacement is done in a high functioning person as risk of dislocation and other complications but gives better function, hemi arthroplasty is done in those with restricted mobility as surgery is less complex but doesn’t give as good function

Question 24

Describe extra capsular proximal femoral fractures and treatment?

Answer 24

these should not cause AVN and have a high union rate

most are fixed with internal fixation keeping the patients own natural hip joint