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22 Cards in this Set
- Front
- Back
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What are the two poorly prognostic factors for nonoperative treatment of midshaft clavicle fractures?
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Shortening >2 cm
Comminution |
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What is the Neer classification of lateral third clavicle fractures?
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I: conoid, trapezoid ligaments intact
II: trapezoid intact to lateral fragment,conoid out to medial fragment III: extension into AC joint |
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Of these, which type is least stable and has highest risk of nonunion?
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ll
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When does the medial clavicular physis close? What is the clinical significance?
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At 24 years of age
Prior to closure, apparent dislocation may actually be a physeal injury |
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A posterior sternoclavicular (SC) dislocation may be associated with what additional injury?
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Tracheal compression
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How should an acute posterior SC dislocation be treated?
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Closed reduction if acute (<10 days) regardless of symptoms
Perform in operating room with chest prepped and draped and vascular support available |
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How is sternoclavicular arthritis refractory to nonoperative management treated?
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Medial clavicular excision
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What structures must be identified and protected during this procedure?
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Leave costoclavicular ligaments (especially posterior)
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Why?
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Necessary for stability
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What are the two components of the initial treatment of distal clavicular osteolysis?
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Sling and antiinflammatories
Injections |
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If unresponsive to conservative management, then what is the operative treatment?
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Distal clavicle resection
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What structure must be identified and protected during this procedure? Why?
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Posterosuperior AC joint capsule
lf injured, AP instability of the clavicle may result |
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If osteolysis is present bilaterally, what condition must be considered?
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Hyperparathyroidism
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What are the two operative indications for scapular neck fractures (Ideberg types 3, 4, and 5)?
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>l cm displacement
>4O degrees angulation |
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What is the preferred surgical approach?
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Posterior Qudet) approach
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How do reported operative and nonoperative outcomes of floating shoulder injury compare?
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Equivalent, assuming individual injuries meet criteria for nonoperative treatment
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What is the radiographic characteristic of a scapulothoracic dissociation?
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Medial scapular border displaced laterally from spine
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What structure is often injured in association?
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Subclavian artery
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What is the etiology of a snapping scapula?
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Scapulothoracic crepitus
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I What are the two operative indications for glenoid fracture without scapular involvement?
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Involvement of >25% articular surface
Glenohumeral joint subluxation or instability |
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What is the preferred surgical approach?
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Deltopectoral
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What is the operative indication for a coracoid fracture?
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>l cm displacement
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