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C D exam 3 > UE Fracture part 2 > Flashcards

UE Fracture part 2 Flashcards

1
Q

forearm fracture of a single bone w/o disruption of the radioulnar joints is which type of fracture

A

stable

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2
Q

Radius and ulna along with proximal and distal radioulnar joints create a stable ring which can be injured in which fracture

A

forearm fracture

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3
Q

forearm fracture of both bones w/o disruption of the radioulnar joints is which type of fracture

A

unstable fracture

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4
Q

forearm fracture of single bone w/ disruption of one radioulnar joint is which type of fracture

A

unstable fracture

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5
Q

forearm fracture most common MOI

A

high impact injuries such as MVA or a fall for height, such as a ladder

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6
Q

another MOI for a forearm fracture is

A

a direct blow

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7
Q

describe a nightstick fracture

A

it is a stable forearm fracture that is in the mid to distant ulnar shaft region
the management is non surgical, using a functional forearm brace

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8
Q

what is a both bone former fracture

A

Radial shaft fracture and ulnar shaft fracture
this fracture is unusable
management is surgical

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9
Q

what is a Monteggia fracture

A

mid to proximal ulnar shaft fracture with an associated radial head dislocation
this fracture is unusable
management is surgical

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10
Q

what is a Galiazzi fracture

A

Mid to distal radial shaft fracture with an associated carpoulnar dislocation
this fracture is unusable
management is surgical

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11
Q

common name for a Flexor Tendon Avulsion Fracture

A

jersey finger

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12
Q

Flexor Tendon Avulsion Fracture MOI

A

Traumatic forced extension of actively flexed finger leads to an avulsion of flexor tendon at base of distal phalanx
Other mechanisms include spontaneous tendon rupture seen in patients with RA

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13
Q

Flexor Tendon Avulsion Fracture clinical presentation

A

the 4th finger (ring finger is most common)

there will be a visible deformity and the patient will be unable to flex the affected finger at DIP

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14
Q

which joint is affect in Flexor Tendon Avulsion Fracture

A

DIP

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15
Q

Flexor Tendon Avulsion Fracture management

A

need early surgical repair (7-10days leads to best recovery)

split the finger in whichever finger it presents and refer to hand surgeon

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16
Q

Distal Phalanx Fracture MOI

A

direct blow from like a hammer or root

many patients have subungal hematoma so be cautious

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17
Q

Distal Phalanx Fracture no surgical management

A

splitting– majority of all fx

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18
Q

Distal Phalanx Fracture surgical management

A

if the fracture is open, angulated more than 15 degrees and displaced more than 2 mm, if conservative management fails or if theres is non- union surgery is needed

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19
Q

Extensor Tendon Avulsion Fracture is also known as

A

Mallet finger

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20
Q

which joint are you unable to extend in an Extensor Tendon Avulsion Fracture

A

DIP joint

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21
Q

Extensor Tendon Avulsion Fracture MOI

A

Traumatic injury to the tip of a fully extended finger leading to avulsion of extensor tendon at base of distal phalanx

Other mechanisms include tendon rupture or tendon laceration

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22
Q

Extensor Tendon Avulsion Fracture clinical presentation

A

visible deformity and an inability to extend the affected DIP joint

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23
Q

Extensor Tendon Avulsion Fracture non surgical management

A

Continuous splinting for 6-8 weeks

but if extension is lost at any point, healing is disrupted and the clock starts again

24
Q

Extensor Tendon Avulsion Fracture surgical management

A

if there is failure to heal with conservative care, or if the tendon is completely lacerated or is the the fracture involves more than 30% of the articular surface

25
Q

Mallet fracture treatment

A

drill .035 k wire through distal phalanx into the middle phalanx and the avulsed fracture is reduced, loop by be needed
the finger is then splinted fir 6 weeks and then k wire is removed

26
Q

Distal Radial Fracture MOI colle’s Fx

A

FOOSH w/ wrist in EXTENSION this is most common

27
Q

Distal Radial Fracture MOI smith’s Fx

A

FOOSH w/ wrist in FLEXION

28
Q

common fracture for postmenopausal women

A

Colle’s Fracture

29
Q

Colle’s Fx clinical presentation

A

dinner fork deformity
localized swelling
potential for median nerve injury
Significant ROM limitation

30
Q

Smith’s Fx clinical presentation

A

garden spade deformity
localized swelling
potential for median nerve injury
Significant ROM limitation

31
Q

which Xray should you get for a colle’s fracture

A

AP and lateral and oblique view

32
Q

which Xray should you get for a smith’s fracture

A

AP and lateral and oblique view

33
Q

Colle’s Fracture Reduction

A

closed manipulation, wrist dorsiflexed

34
Q

Distal Radial Fracture non surgical management

A

if it is not displaces give a short arm case

if it is displaces give a long arm cast to maintain reduction

35
Q

Distal Radial Fracture surgical management

A

used when there is a Neurovascular injury, the fracture is open, there is and Intra-articular extension, theres is Severe comminution or if there is an Inability to maintain reduction

36
Q

Pediatric Distal Radial Fracture

A

a pediatric distal radial fracture
it is most common in children under 10
Distal metaphysis
Buckling of cortex due to compression failure

37
Q

Radial Torus “Buckle” Fracture MOI

A

FOOSH

38
Q

Radial Torus “Buckle” Fractureclinical presentation

A

mild to moderate swelling, guarded limited ROM, no visible deformity

39
Q

Radial Torus “Buckle” Fracture management

A

short arm was for 4 to 6 weeks

40
Q

radial Greenstick fracture

A

a pediatric distal radial fracture
less common than buckle
Complete fracture of the TENSION side of the cortex with buckling of the compression side

41
Q

radial Greenstick fracture MOI

A

FOOSH

42
Q

radial Greenstick fracture clinical presentation

A

mild to moderate swelling, guarded limited ROM, a visible deformity may be present

43
Q

radial Greenstick fracture management

A

Short arm cast for 6-8 weeks

Rarely require surgical management unless significant angulation, neurovascular injury, or Open Fx

44
Q

Scaphoid Fracture

A

the most common fractured carpal bone
MOI is FOOSH

Clinical findings
Snuffbox pain / TTP
ROM limitations
Common for Fx to be occult on initial x-ray

45
Q

Scaphoid Fracture limited blood supply

A

high incidence of nonunion and osteonecrosis

46
Q

greenstick on x ray

A

complete disruption on one side with buckle on opposite side

47
Q

when is 5th Metacarpal “Boxer’s” Fracture non surgical Management used

A

less than 15 degrees of angulation

Transverse, oblique, base & head Fx

48
Q

when to get a surgical consult for a 5th Metacarpal “Boxer’s” Fracture

A

Open fracture, > 15 degrees angulation, Intra-articular, Comminuted fx, Spiral fx

49
Q

5th Metacarpal “Boxer’s” Fracture

A

MC fracture of the hand
Distal metaphysis of 5th metacarpal
MOI is Closed fist striking an object

50
Q

5th Metacarpal “Boxer’s” Fracture clinical presentation

A

Localized swelling
+/- malrotation deformity
+/- dropped knuckle deformity

51
Q

malrotation

A

pinkie over ring finger

52
Q

Scaphoid Fracture – Management

A

Long-arm thumb spica cast for 6-12 weeks

If clinical exam is indicative of fracture but x-rays are negative, splint and repeat x-rays in 10-14 days
If follow up x-rays still negative but clinical concern persists order MRI

53
Q

Displaced transverse and oblique fractures tend to

A

angulate

54
Q

Spiral fractures tend to

A

rotate

55
Q

for Fractures of the Metacarpals and Phalanges, Ortho referral for surgical evaluation when?

A

Displaced (> 2mm), spiral, comminuted and intra-articular fractures
Uncorrected angulation and malrotation

C D exam 3 (2 decks)

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