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emergency med final > upper extremity ortho > Flashcards

upper extremity ortho Flashcards

1
Q

patients with a clavicle fracture will have more pain in what position

A
  • lying flat
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2
Q

tx of non-displaced or pediatric clavicle fracture

A
  • 8-12 weeks
  • figure 8 or sling
  • muscle relaxant beneficial
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3
Q

surgery option for clavicle fracture

A
  • ORIF
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4
Q

MOI of scapula fracture

A
  • high energy injury
  • typically associated with other trauma
    • evaluate UE, torso, spine
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5
Q

tx for scapula fracture

A
  • 6 months -1 year
  • conservative
    • sling/shoulder immobilizer
    • surgery rarely indicated
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6
Q

MOI for proximal humerus fracture

A
  • young: high energy trauma
  • elderly: simple fall
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7
Q

Neer classification used for

A

proximal humerus fracture

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8
Q

What specific neurovascular function must you evaluate for in a humerus fracture

A
  • radial nerve
    • wrist drop
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9
Q

if patient has a humerus fracture, r/o pathologic fx caused by

A
  • unicameral bone cyst
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10
Q

why would you promote early motion in patient with humeral shaft fracture

A
  • prevent frozen shoulder
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11
Q

Glenohumeral dislocations most often occur

A
  • anteriorly
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12
Q

physical exam tests for Glenohumeral dislocations

A
  • sulcus sign
  • apprehension and relocation test
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13
Q

what view is best for posterior Glenohumeral dislocations

A
  • axillary view
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14
Q

if you reduce Glenohumeral dislocation and ROM does not return, be suspicious for

A
  • axillary nerve injury
  • rotator cuff tear
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15
Q

tx for Glenohumeral dislocations

A
  • reduction
  • shoulder immobilizer: sling and swathe 2-4 weeks (short duration)
    • limit frozen shoulder
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16
Q

what is a Bankart lesion

A
  • detachment of anterior inferior labrum from glenoid rim
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17
Q

what is a Hills Sachs lesions

A
  • cortical depression of the posterolateral humeral head when humeral head is impacted by anterior rim of glenoid
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18
Q

if patient with an anterior glenohumeral dislocation has decreased sensation to the lateral aspect of the shoulder (mid deltoid) and decreased deltoid function (abduction) be suspicious of

A

axillary nerve damage

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19
Q

supracondylar fracture

A

fracture of the distal humerus just above the epicondyles

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20
Q

what special neurovascular exam should you do with supracondylar fracture

A
  • anterior interosseos nerve coming off medial nerve
  • okay sign
21
Q

when looking at radiograph images for suspected supracondylar fracture, what are you looking for

A
  • anterior humeral line must intersect the capitellum
22
Q

distinguish between subluxation vs dislocation

A
  • Dislocation (a complete disruption of the joint) and subluxation (a partial dislocation followed by relocation)
23
Q

nursemaids elbow. description and cause

A
  • dislocation of radial head
    • common cause: sudden pull of pronated arm in 1-4 y.o
24
Q

what must you remember to get when ordering imaging for forearm fractures

A
  • include elbow to r/o dislocation or fracture
25
what is a Monteggia fracture
* **ulnar** (or radial and ulnar) shaft **fracture** with **dislocation of radial head**
26
Nightstick fracture
* isolated ulnar shaft fracture * nighstick (defensive)
27
biggest risk of elbow and forearm fractures
* compartment syndrome * Pain, pallor, paresthesias, pulselessness, paralysis
28
a complication of elbow and forearm fractures is volkmann's ischemic contracture which is
* flexor shortening * brachial artery obstruction
29
For a wrist fracture, evaluate neurovascular function via
* thumbs up : radial * okay sign: medial * scissors: ulnar
30
MOA of Colles fracture
* dorsal displacement causes wrist fx * dinner form deformity
31
MOA of smiths fx
* volar displacement causing wrist fx
32
cast smiths fx in what position
* supination * extension
33
tx for wrist fracture
* +/- reduction * splint * casting 4-6 weeks * ? surgery
34
What is a Galeazzi fracture
* distal radius fx with disruption of distal radioulnar joint (DRUJ)
35
how is scaphoid fx diagnosed
* clinical dx * TTP over anatomic snuffbox * radiographs may be negative. repeat x-rays in 2 weeks to detect delayed findings
36
border of scaphoid fx
* lateral border * extensor pollicis brevis * abductor pollicis longus * medial * extensor pollicis longus
37
tx of scaphoid fx
* thumb spica * surgery required for displaced fractures
38
which aspect of scaphoid is at highest risk for avascular necrosis if fractured
* proximal aspect of scaphoid
39
what type of PIP dislocation is most common
dorsal dislocation
40
What is jersey finger
* **Flexor tendon rupture** * inability to **flex DIP** joint * ring finger most common
41
tx of jersey finger
* surgical * direct tendon repair/reinsertion * repair in 10-14 days to prevent tendon shortening
42
what is a Mallet finger
* **rupture of extensor tendon** * inability to **extend DIP**
43
tx of Mallet finger
* STAT extension splint 6-8 weeks * surgery with large fx fragment or subluxation at joint
44
boutonniere deformity
* flexion of PIP joint * hyperextension at DIP * ruptured central slip extensor tendon
45
swan neck deformity
* hyperextension of PIP joint * flexion of DIP joint * volar plate attenuation of PIP joint
46
boxer's fracture
* fx to neck of 5th metacarpal
47
degrees of angulation allowed before surgery required for metacarpal fractures
* 10, 20, 30, 30 * ex: boxers fracture can have up to 30 degrees of angulation
48
what is a Bennett's fracture
* fracture to the base of 1st metacarpal
49
what is a game keepers thumb (skier's thumb)
* injury to the MCP joint resulting in a ulnar collateral ligament tear and instability of MCP joint

emergency med final (4 decks)

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