Week 6 Flashcards
What are soft tissue injuries well demonstrated by?
MRI and US
What can image tendons really well?
US
Name three typical sites of impacted fractures of the lower lib?
- Femoral neck
- Tibial plateau
- Calcaneus
What energy status are pelvic ring fractures in young people?
High energy
What two methods are pelvic ring fractures typically due to?
RTA and fall from height
What is the primary imaging technique in all polytrauma patients?
CT
What energy status are pelvic ring fractures in elderly patients with osteoporosis?
Low energy
What is the imaging of choice for low energy pelvic ring fractures?
MRI
Give two features of a typical hip dislocation?
- Posterior
2. With acetabular rim fracture
What is the most useful fracture classification?
Intra versus extracapsular
What type of proximal femoral fracture interferes with blood supply to femoral head, is prone to femoral head AVN or non-union and is treated by hemiarthroplasty, unless undisplaced or young patient where reduction may be tried?
Intra-capsular
How are extra-capsular fractures of proximal femor treated?
By internal fixation using DHS
What two things are at risk with a femoral shaft fracture?
Blood loss
Fat embolus
What is a specific sign of an intra-articular fracture of knee?
Lipohaemarthrosis collecting in suprapatellar recess
What parts of extensor mechanism injury can be easily clarifeid by US?
quadriceps and patellar tendon tears
What can excessive inversion or eversion of the ankle cause?
Talar dome margin fracture
What does calcaneal fracture usually follow?
Axial compression - fall from height
In adolescents what does the 5th metatarsal have at its base?
Longitudinal accessory ossification centre
What is the os trigonum?
An accessory ossification centre commonly seen posterior to talus
Name three things which predispose to tendon rupture?
Diabetes, RA and steroid use
Name the three forms of blood supply to femoral head?
- Intramedullary artery of shaft of femur
- Medial and lateral circumflex branches of profunda femoris
- Artery of ligamentum teres
Give two signs of a proximal femoral fracture?
- Shortening
2. External rotation
Give three steps in secondary bone healing
- Fracture gap fills with granulation tissue
- Then cartilage (soft callus)
- Then bone (enchondral ossification, hard callus)
If a high energy fracture - what should be done first?
Resuscitation - ABCD