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C D exam 3 > UE Fractures part 1 > Flashcards

UE Fractures part 1 Flashcards

1
Q

what is the most common MOI for a clavicular fracture

A

Direct fall on the shoulder with arm at side

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2
Q

what is the another MOI for a clavicular fracture

A

a direct blow

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3
Q

risk factors for clavicular factors

A

contact sports and being a male until age 75

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4
Q

what age do females become more likely to experience clavicular fractures

A

over 75 years old

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5
Q

how does a clavicular present

A

deformity at fracture site usually midline
defect may be palatable
crepitus with AROM

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6
Q

with a clavicular Fracture a neuromuscular exam is needed due to

A

the subclavian vessels and the brachial plexus

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7
Q

Clavicular Fracture locations in order of likely hood

A

middle
distal
medial

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8
Q

is a Clavicular Fracture a non operative treatment?

A

typically yes

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9
Q

how do manage Clavicular Fracture

A

sling or figure 8 brace (sling provide more comfort and results and alignment are identical)

choice usually based upon provider preference

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10
Q

when do you need surgical management for a Clavicular Fracture (definitive indications)

A

it is an open fracture
there is a neruovascular injury
tenting of the skin is present

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11
Q

when do you need surgical management for a Clavicular Fracture (relative indications) (5)

A
  1. widely displace fractures
  2. multiple fracture segments
  3. displaced laterally (distal 1/3 fractures)
  4. the clavicle fracture is on the dominant extremity in overhead athlete (throwing, baseball, volleyball, tennis)
  5. cosmetic concerns
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12
Q

most common Proximal Humerus Fracture MOI

A

fall onto an outstretched hand

direct trauma may also cause this

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13
Q

Proximal Humerus Fracture other MOI age groups

A

simple fall in older people (increased fall risk and decreased bone density)
high energy trauma in young patients

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14
Q

Proximal Humerus Fracture clinical presentation

A

swelling, ecchymosis, pain, guarding, limited ROM

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15
Q

1 part Proximal Humerus Fracture

A

Surgical neck, anatomic neck, lesser tuberosity or greater tuberosity
Any fracture pattern with less than 1 cm displacement

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16
Q

2 part Proximal Humerus Fracture

A

Surgical neck, anatomic neck, lesser tuberosity or greater tuberosity
Fragments must be displaced by 1 cm

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17
Q

3 part Proximal Humerus Fracture

A

Surgical neck and greater tuberosity or surgical neck and lesser tuberosity
Fragments must be displaced by 1 cm

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18
Q

4 part Proximal Humerus Fracture

A

Surgical neck, lesser and greater tuberosities

Fragments must be displaced by 1 cm

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19
Q

non surgical Proximal Humerus Fracture management need for

A

neer type 1

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20
Q

surgical Proximal Humerus Fracture management need for

A 
associated neurovascular injury
Open Fx
Neer types 2, 3, and 4
Significant distortion of the bicipital groove
Fracture dislocation
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21
Q

Midshaft Humerus Fracture MOI

A

there is a direct blow to humerus
or a bending force applied to the humerus

falling on an out starched hand can also cause this type of fracture this however is a PATHOLOGIC FRACTURE

22
Q

is a pediatric patient presents with Midshaft Humerus Fracture suspect what?

A

child abuse

23
Q

Midshaft Humerus Fracture clinical presentation

A

swelling, ecchymosis

a visible shortening may be present

24
Q

radial nerve neurological screen sensory

A

dorsum of hand

25
Q

radial nerve neurological screen motor

A

perform wrist dorsiflex

26
Q

medial nerve neurological screen sensory

A

palmar aspect of thumb

index finger middle fingers

27
Q

ulnar nerve neurological screen sensory

A

palmar aspect of pinkie

28
Q

ulnar nerve neurological screen motor

A

perform finger abduction

29
Q

medial nerve neurological screen motor

A

perform thumb opposition

30
Q

Midshaft Humerus Fracture vascular screen

A

distal pulses radial and ulnar

cap refill

31
Q

the majority of the time Midshaft Humerus Fracture is managed how?

A

non surgical with a functional humerus brace

32
Q

Early shoulder range of motion in mid shaft humerus should be done to

A

reduce the risk of adhesive capsulitis

33
Q

what is and adhesive capsulitis also known as

A

frozen shoulder

34
Q

when are surgical interventions used for a mid shaft humerus fracture?

A 
Neurovascular injury
Open Fx
Pathologic Fx
> 3 cm shortening
> 30° angulation
35
Q

Pediatric ossification centers (CRITOE)

A 
Capitellum 
Radial head
Internal (medial) epicondyle
Trochlea
Olecranon
External (lateral) epicondyle
36
Q

Supracondylar Fracture most common MOI

A

hyperextension injury associated with falling on outstretched hands, resulting in a extension Supracondylar Fracture

37
Q

other Supracondylar Fracture MOI

A

a direct blow that will cause a extension or flexion type Supracondylar Fracture

38
Q

Supracondylar Fractures are seen more commonly in which patient population

A

pediatrics

39
Q

Supracondylar Fracture clinical presentation

A

possible palatable displaced fragment
swelling ecchymosis
Potential for neurovascular injury
Forearm compartment syndrome

40
Q

Forearm compartment syndrome results in what and presents as what

A

Volkmann’s ischemia / contracture
Marked swelling of the forearm
Palpable tenseness
Pain with passive extension of the finger

41
Q

Supracondylar Fracture can mimic which dislocation

A

posterior elbow dislocation

42
Q

when do we use a non surgical approach to Supracondylar

A

type I and type II with reduction

43
Q

when do we use a surgical approach to Supracondylar

A

theres a neuromuscular injury
open fracture
type III

44
Q

Radial Head fracture Most common MOI

A

FOOSH w/ partially flexed elbow

45
Q

Radial Head fracture additional MOI

A

Posterior elbow dislocation

46
Q

Radial Head fracture clinical presentation

A

swelling over lateral elbow

limited ROM

47
Q

which ROMs are especially difficult for patients with Radial Head fracture

A

Extension, supination

48
Q

which type of x ray should you get for a suspected Radial Head Fracture
and what sign are you looking for

A

AP, lateral views AND oblique view
look for fat pad sign

*Type I Fx may be occult on initial x-rays

49
Q

Radial Head Fracture type I Non surgical

A

Splint or sling for 5-7 days
allow patients to use the sling for comfort after this time period
Early ROM

50
Q

Radial Head Fracture type II Non surgical – Minimal displacement

A

Minimal displacement
Splint for 10-14 days
allow patients to use the sling for comfort after this time period
Aggressive ROM after splint removal

51
Q

Radial Head Fracture type II Moderate displacement management

A

open reduction and internal fixation (ORIF)– surgical intervention

52
Q

Radial Head Fracture type III management

A

surgery

C D exam 3 (2 decks)

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