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MSK > Trauma week > Flashcards

Trauma week Flashcards

1
Q

What AC joint injuries are possible?

A

Sprain
Subluxation
Dislocation

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2
Q

What tends to cause AC joint injuries?

A

Fall onto outstretched arm

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3
Q

What is a subluxed AC joint?

A

Rupture of the AC ligament

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4
Q

What is a dislocated AC joint?

A

Coracoclavicular and AC ligaments break

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5
Q

How do you treat AC joint injuries?

A

Sling and physio

Surgery for chronic pain

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6
Q

What are the three directions the glenohumeral joint can dislocate?

A

Anterior
Posterior
Inferior

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7
Q

How do you diagnose a glenohumeral joint dislocation?

A 
Asymmetry
Arm held adducted
Loss of sensation on regimental badge
2 plane XR
Posterior shows light bulb sign on XR
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8
Q

What are the three common humeral neck fractures?

A

Proximal- Along surgical neck, Usually osteoporosis
Tuberosity fracture
Head fracture

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9
Q

How does a proximal humeral neck fracture present?

A

Medial displacement

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10
Q

How do you treat a humeral neck fracture?

A

Minimally displaced- Sling and gradually mobilize
Displaced- Wait for muscle spasm to ease and see
Permanently displaced- Internal fixation

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11
Q

How do you treat multiple fractures of the humeral neck/head?

A

Joint replacement but not the best.

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12
Q

What are the two ways a humeral shaft can break?

A

Direct trauma- Transverse fracture

Falling- Oblique or spiral fracture

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13
Q

How do you fix a broken humeral shaft?

A

Usually just brace
Can fix with intramedullary nail
High recovery rates

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14
Q

What is a complication of a broken humeral shaft?

A

Damage to the radial nerve running in groove leading to loss of sensation in 1st dorsal webbing and wrist drop.

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15
Q

What age group do supracondylar fractures tend to occur in?

A

Children

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16
Q

How are supracondylar fractures occur?

A

Fall onto outstretched arm or flexed elbow

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17
Q

How do you treat a supracondylar fracture?

A

Undisplaced- Splint

Displaced- Reduce. Pin w/ wires or open surgery if artery/nerve is trapped.

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18
Q

How do you get an olecranon fracture?

A

Fall on point of elbow

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19
Q

How do you treat an olecranon fracture?

A

Open reduction and internal fixation.

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20
Q

What is problematic about forearm fractures?

A

If one bone breaks other has to break or dislocate normally

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21
Q

What is an ulnar shaft/nightstick fracture?

A

Isolated fracture of ulna due to direct blow.

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22
Q

How do you manage an ulnar shaft fracture?

A

Conservative management normally but can be ORIF

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23
Q

What is a Monteggia fracture dislocation?

A

Fracture of ulna and dislocation of radial head

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24
Q

How do you treat a Monteggia fracture dislocation?

A

ORIF of fracture which usually relocated radius

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25
Q

What is a Galeazzi fracture dislocation?

A

Fracture of radius and dislocation of ulnar at distal radioulnar joint.

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26
Q

How do you treat a Galeazzi fracture?

A

ORIF of radius which normally resets ulnar

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27
Q

What is a both bone fracture of the forearm?

A

A fracture through diaphysis of both ulnar and radius

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28
Q

How do you treat a both bone fracture of the forearm?

A

ORIF in adults

Plaster cast in children as will remodel better

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29
Q

What kind of fractures are possible at the distal radius?

A

Colles Fracture
Smith’s Fracture
Barton’s Fracture
Comminuted intra-articular distal radius fracture

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30
Q

What is the most common cause for distal radius fractures?

A

Fall on to out stretched arm

31
Q

What is a Colles fracture?

A

Fracture of distal radius w/in 1 inch of articular surface with dorsal displacement.

32
Q

How do you treat a Colles fracture?

A

Minimal displacement- Splint
Displaced- Manipulate then splint
Then secure with plaster, percutaneous wires or ORIF

33
Q

What complication can a Colles fracture cause?

A

Carpal tunnel syndrome

34
Q

What is a Smith’s fracture?

A

Fracture of distal radius w/in 1 inch of articular surface with volar displacement.

35
Q

How do you treat a Smith’s fracture?

A

ORIF

36
Q

What is a Barton’s fracture?

A

Intra-articular fracture of distal radius- carpal bones sublux and break off part of rim.
Can be volar or dorsal

37
Q

How do you treat a Barton’s fracture?

A

ORIF

38
Q

What is a comminuted intra-articular distal radius fracture?

A

Very traumatic and damaging fracture of radius

39
Q

How do you treat a comminuted intraarticular distal radius fracture?

A

External fixation

40
Q

What normally causes a scaphoid fracture?

A

FOOSH

41
Q

How does a scaphoid fracture present?

A

Tenderness in anatomical snuff box
Pain on compression
Difficult to see on XR therefore splint and asses in 2 weeks

42
Q

How do you treat a fractured scaphoid?

A

Undisplaced- Cast for 6-12 weeks

Displaced- Compress and screws

43
Q

What complications can occur with a broken scaphoid?

A

Due to poor blood supply can un-union and AVN.

44
Q

What are the 6 hand injuries we need to know

A 
Phalangeal fractures
Metacarpal fractures
Flexor tendon injury
Penetrating hand injury
Extensor tendon injury
Mallet fracture
45
Q

How do you treat phalangeal fractures?

A

Strap to neighbours

If angles will need manipulated under ring block

46
Q

How do you treat metacarpal fractures?

A

3rd, 4th and 5th treat conservatively

5th tend to angle therefore strap digit to neighbour

47
Q

What is a special form of metacarpal fracture?

A

Fight bite

48
Q

What is the danger with fight bite?

A

Caa get oral bacteria in MCP capsule giving septic arthritis or disrupt extensor mechanism

49
Q

What is a major problem with flexor tendon injury?

A

Potential for damage to nerves and arteries

50
Q

What tendons can be damaged in flexor tendon injury?

A

FDS
FDP
FPB

51
Q

How do you treat flexor tendon injury?

A

Repair and splint in flexed position

52
Q

What is mallet finger?

A

Avulsion of extensor tendon from its insertion into terminal phalanx

53
Q

How does mallet finger occur?

A

Forced flexion of extended DIP joint

54
Q

How does mallet finger present?

A

Pain
Droop at DIP
Inability to extend DIP

55
Q

How do you treat mallet finger?

A

Hold extended for 4 weeks

56
Q

How do you treat extensor tendon injury?

A

If more than 50% then requires surgical repair with splint in extension for 6 weeks.
Flexion may cause healing failure

57
Q

What is the danger with penetrating hand injuries?

A

Volar injuries can damage flexor tendons, digital nerves and arteries
Dorsal injuries can damage extensor tendons

58
Q

How do you treat penetrating hand injuries

A

Repair damaged tendons etc

59
Q

What are the five categories of Salter-Harris physeal injury?

A

1: Pure separation along physeal line
2: Similar to 1 but with small bit of metaphysis attached.
3: Interarticulate progressing to physis
4: Interarticulate progressing into metaphysis
5: Compression of physis therefore get growth arrest

60
Q

What is the most common Salter-Harris physeal injury?

A

Salter-Harris II

61
Q

What are some indicators of Non-Accidental Injury in children?

A

Multiple fractures and bruises at different stages of healing.
Multiple trips to A&E
Changes/discrepancy in history- Both between carers and not matching injuries
Atypical injuries
Rib and metaphyseal injury

62
Q

What is a buckle fracture?

A

Compression of the bone therefore looks slightly short and wide on XR.

63
Q

How do you treat a buckle fracture?

A

3-4 weeks in a splint

64
Q

What is a greenstick fracture?

A

Part of bone remains attached and part breaks.

65
Q

How do you treat a greenstick fracture?

A

Manipulation and casting

66
Q

What fractures can you get in the forearm of a child?

A

Monteggia and Galeazzi fracture dislocations

Fractures of both bones

67
Q

How do you treat fractures in the forearm of a child?

A

Monteggia and Galeazzi fracture dislocations- ORIF

Fractures of both bones- Undisplaced cast, displaced need fixed

68
Q

What is the most common fracture of a child’s elbow?

A

Supracondylar fracture

69
Q

How do children tend to obtain supracondylar fractures?

A

Extensor- fall on outstretched arm

Flexor- fall on point of elbow

70
Q

How do you treat supracondylar fractures?

A

Undisplaced- Stabilized and splint

Displaced- MAnipulate ASAP and surgery if artery (no pulse) or nerve (no feeling) involvement

71
Q

How do kids tend to fracture their femoral shaft?

A

Fall on bent knee
Direct bending force
Rotation

72
Q

How do you treat a fractured femur in kids?

A

<2YO- NAI therefore treat appropriately
2-6YO- Splint or cast
6-12YO- Flexible intramedullary nails
>12YO- Adult type intramedullary nails

73
Q

What type of tibial fracture is common in toddlers?

A

Undisplaced spiral fracture

74
Q

How do you treat a tibial fracture in children?

A

Cast if stable

If open or unstable- Fix and screws

MSK (17 decks)

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