UE Orthopedics (Exam #4) Flashcards
What does SALTR stand for?
- S = separation
- A = above
- L = lower
- T = through
- R = rammed/ruined (crush injury)
What SALTR is the most common?
TYPE II
KNOW THIS
What bone is most often involved in open fractures?
Tibia
What is the recommended tx for all open fractures? What may be added if contaminated?
Emergent IV Cephazolin
+ Aminoglycoside if contaminated
What two things can affect risk for Osteomyelitis?
- Quality of surgical debridement
- Prophylactic abx
What is typically the MOI for Scapula Fracture?
HIGH energy injury (MVA, fall, direct trauma)
What are the two most common MOI for Proximal Humerus Fracture?
- High energy trauma in young
- Fall in elderly
What dx criteria is used for Proximal Humerus Fracture?
Neer Classification
What nerve MUST be evaluated with a Humeral Shaft Fracture, and HOW is this done?
Radial n.
- Wrist drop (wrist extension with “motorcycle vroom vroom”)
What associated injury may be seen with a Humeral Shaft Fracture?
Forearm fracture (“floating elbow”)
What direction is more common with a Glenohumeral Dislocation?
ANTERIOR
What two tests can be used to evaluate for Glenohumeral Dislocation?
- Sulcus sign
- Apprehension and Relocation test
What is the recommended tx for Glenohumeral Dislocation? What other tx is often added as adjunct?
IMMEDIATE reduction
- PT
What are two possible complications of an ANTERIOR Glenohumeral Dislocation?
- Bankart Lesion
- Hills Sachs Lesion
What condition involves a anterior/inferior Labrum detaches from glenoid rim?
What is it a complication of?
Bankart Lesion
- Complication of an ANTERIOR Glenohumeral Dislocation
What condition involves a compression fracture or “dent” of the posterosuperolateral humeral head?
What is it a complication of?
Hills Sachs Lesion
- Complication of an ANTERIOR Glenohumeral Dislocation
What nerve may be affected with a Glenohumeral Dislocation?
How will this present for both motor AND sensory?
Axillary n.
- Decreased sensation in lateral aspect of shoulder
- Decreased abduction of deltoid
What sign indicates a possible elbow fracture?
Elbow Fat Pad Sign (“sail sign”)
Subluxation vs. Dislocation?
- Subluxation = partial dislocation
- Dislocation = complete dislocation
What is the recommended tx for an Elbow Subluxation/Dislocation? What is an important factor in early tx?
IMMEDIATE reduction
- Early immobilization
What is an important consideration with a Forearm Fracture?
Evaluate for multiple injuries
- Open fracture
- 2 fractures
- Fracture + dislocation
What two bones are often affected with a Forearm Fracture? What other injury may be seen?
Radius and/or Ulna
- Clinical deformity with dislocation
What injury presents with restricted ROM with supination and pronation?
Forearm Fracture
What two movements are often restricted with a Forearm Fracture?
- Supination
- Pronation
What is the first line med tx for a NON-displaced Forearm Fracture?
NSAIDs
What condition involves an ulnar or radial shaft fracture WITH radial head dislocation?
Monteggia Fracture
What is a Monteggia Fracture?
Ulnar or radial shaft fracture WITH radial head dislocation
Differentiate Colles Wrist Fracture from a Smith’s Wrist Fracture.
- Colles = dorsal displacement (outward)
- Smith’s = volar displacement (inward)
What condition involves a dorsal displacement at the wrist?
Colles Wrist Fracture
What condition involves a “dinner fork” deformity?
Colles Wrist Fracture
What condition involves a volar displacement at the wrist?
Smith’s Wrist Fracture
What condition involves a distal radius fracture with disruption/dislocation at wrist ?
Galeazzi Fracture
What is a Galeazzi Fracture?
Distal radius fracture with disruption/dislocation at wrist
What is the most common carpal bone fractured in wrist?
Scaphoid
What is the recommended dx for a Scaphoid Fracture, and what does this look like?
CLINICAL
- TTP of “anatomic snuffbox”
What is a major complication of a Scaphoid Fracture, and what area of the Scaphoid specifically?
Avascular Necrosis
- Proximal aspect of scaphoid most at risk for AVN
What is Avascular Necrosis, and what is it a complication of?
Complication of a Scaphoid Fracture
- Retrograde blood flow from dorsal and volar branches of Radial a.
What direction of an IP Dislocation is more common?
Dorsal
What is the MOA of a Subungual Hematoma?
Crush injury
What tx is needed if there is an associated distal phalanx fracture with Subungual Hematoma?
Prophylactic abx
What condition involves flexor tendon rupture (FDP)?
Jersey Finger
What condition involves an inability to flex at the DIP joint?
Jersey Finger
What condition involves extensor tendon rupture (DIP)?
Mallet Finger
What condition involves an inability to extend at the DIP joint?
Mallet Finger
What is the recommended tx for a Jersey Finger, and why?
SURGERY within 10-14 days
- Prevent tendon shortening
What condition involves a fracture of the neck of 5th metacarpal?
Boxer’s Fracture
What condition involves a fracture of the base of 1st metacarpal WITH extension into joint?
Bennett’s Fracture
When reducing a Boxer’s Fracture, how much angulation is allowed?
What deformity should NOT be seen post-reduction?
Can allow up to 30 degree angulation
- NO rotational deformity
What condition involves an MCP joint injury → ulnar collateral ligament tear and MCP joint instability?
Game Keepers Thumb/Skiers Thumb
What is a Game Keepers Thumb/Skiers Thumb (2)?
- Ulnar collateral ligament tear
- MCP joint instability
What is a Boxer’s Fracture?
Fracture of neck of 5th metacarpal
What is a Bennett’s Fracture?
Fracture of base of 1st metacarpal WITH extension into joint
