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59 Cards in this Set
- Front
- Back
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What is a sprain?
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a ligament injury
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Name and describe the 3 classifications of sprains
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• 1st-degree - localized joint pain and tenderness but no joint laxity
• 2nd-degree - detectable joint laxity with localized pain and tenderness • 3rd-degree - ligaments completely disrupted and joint grossly unstable |
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What is a strain?
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the tearing of a muscle-tendon unit
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What is the difference between a dislocation and subluxation?
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• in a dislocation, the normally opposing joint surfaces are completely displaced
• in a subluxation, those surfaces are partially displaced |
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What is the difference between a volar and dorsal angulation fracture?
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• a volar fracture, the distal portion that is fractured is displaced anteriorly
• a dorsal fracture, the distal portion that is fracture is displaced posteriorly |
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Name and describe the 3 grades of open fractures
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• Grade 1 - open fractures with wounds less than 1 cm in length
• Grade 2 - wounds are greater than 1 cm, but clean without devitalization of tissue • Grade 3 - greater than 1 cm in length, or grossly contaminated, or associated with comminuted fractures and vascular injury |
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What is a salter-harris fracture?
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a fracture through the physis (growth plate) in children
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Describe the 5 types of salter-harris fractures
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• Type I - through the physis
• Type II - through the physis and metaphysis • Type III - through the physis and epiphysis • Type IV - through the physis, metaphysis, and epiphysis • Type V - crush injury to the physis |
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What are the 3 principles of fracture care?
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• reduction of deformity
• maintenance of reduction • rehabilitation of function |
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What are some common complications of musculoskeletal injuries?
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• acute respiratory distress syndrome (from fat embolism)
• DVT • atelectasis • ectopic bone formation • nerve compression • osteomyelitis |
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List 5 types of closed reduction
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• stimson maneuver - pt prone on table with weight on arm
• mitch maneuver • hippocratic maneuver - examiner places sole of foot in axilla • traction/countertraction • scapular manipulation - stimson maneuver with medial manipulation of the tip of scapula |
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What are 2 lesions associated with recurrent shoulder dislocations?
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• Bankhart lesion - anterior capsular injury associated with a tear of the glenoid labrum
• Hill-Sachs lesion - compression fracture of the articular surface of the humeral head |
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Name and describe the 3 classes of clavicle fractures
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• Class A - middle third fracture
• Class B - distal third fracture • Class C - proximal third fracture |
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What is a Monteggia fracture?
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a fracture of the mid or proximal ulna with anterior dislocation of the radial head
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What is a Galeazzi fracture?
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a radial shaft fracture with associated dislocation of the distal radioulnar joint
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What is an olecranon fracture?
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like a fractured elbow
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What are the different types of fractures that can occur at the distal humerus?
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supracondylar, medial epicondyle, and lateral epicondyle fracture
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What is a nightstick fracture?
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an isolated ulnar fracture
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What is a Colles fracture?
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• fracture of the distal radius with dorsal displacement
• "silver fork" deformity |
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What is a Smith's fracture?
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• a reverse Colles fracture
• fracture of the distal radius with palmar displacement of the distal fragment • volar displacement of the hand |
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What is the most fractured carpal bone?
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Scaphoid
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What is a Game Keeper's Thumb (or Skier's Thumb)?
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an injury to the ulnar collateral ligament of the metocarpal-phalange joint of the thumb
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What bone is typically fractured in a boxer's fracture?
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5th metacarpal
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What is a Bennett's fracture?
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a fracture of the 1st metacarpal at the carpo-metacarpal joint
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What is a Rolando's fracture?
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a comminuted fracture at the base of the 1st metacarpal
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What are some characteristics of the anterior cruciate ligament?
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• goes from lateral to the medial
• originates from the intercondylar eminance of the tibia and inserts on the posteromedial aspects of the lateral femoral condyle • prevents anterior translation of the tibia |
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What are some characteristics of the posterior cruciate ligament?
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• goes from medial to lateral (originates on the medial femoral condyle and inserts on the tibia)
• prevents posterior translation of the tibia |
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What are some characteristics of the medial collateral ligament (MCL)?
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• originates on the medial femoral epicondyle and inserts on the proximal tibia
• prevents valgus angulation of the knee (L-shaped leg) |
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What are some characteristics of the lateral collateral ligament (LCL)?
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• originates on the lateral femoral epicondyle and inserts on the lateral aspect of the fibular head
• prevents varus angulation of the knee (R-shaped leg) |
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What is the most common knee injury requiring surgery?
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• meniscal tear is most common
• medial meniscal tear is 3x more likely than lateral meniscal tear |
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What is a McMurray test?
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• a test for injury to meniscal structures of the knee in which the lower leg is rotated while the leg is extended
• pain and a cracking in the knee indicates meniscal injury |
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What causes an ACL sprain?
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caused by twisting of knee while foot is firmly planted on ground
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What can cause of PCL sprain?
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caused by hyperextension of knee or direct blow to anterior aspect of flexed knee
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What is the unhappy triad?
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ACL tear, MCL tear, Medial meniscus tear
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What tendon is above the patella? below the patella?
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• the quadriceps tendon is above the patella
• the patella tendon is below the patella |
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What is a common physical finding of a patella tendon rupture?
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• patient cannot actively extend knee
• patella alta (patella is pulled superiorly by quadriceps tendon) |
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A patella dislocation/subluxation is usually displaced in which direction?
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the patella is usually displaced laterally
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Which bone in the foot articulates with the tibia?
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talus
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What is plantar fasciitis?
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inflammation due to repeated overstretching of the plantar fascia ligament (fat pad on the bottom of the foot)
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What is a Hallux Valgus?
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• most common deformity of the foot
• results in excessive valgus angulation of the big toe |
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What does the Lisfranc's ligament attach?
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the 2nd metatarsal to the medial cuneiform
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What is a Lisfranc fracture?
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dorsal dislocation of the proximal base of the 2nd metatarsal
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What is a Jones Fracture?
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transverse fracture of the 5th metatarsal at the junction of the proximal metaphysis and diaphysis
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What is an avulsion fracture?
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• 5th metatarsal (more proximal than Jones Fx)
• aka Pseudo-Jones Fx, dancer Fx, tennis Fx |
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What is a March fracture?
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• stress fracture usually of the middle of the shaft of the 3rd or 4th metatarsal
• history of having gone on a long walk or march with no clear history of trauma |
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Name and describe the 3 classes of metatarsal fractures?
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• Class A - neck fracture
• Class B - shaft facture • Class C - proximal metatarsal fracture (ex Jones fx) |
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What radiologic studies should be ordered with a calcaneus fracture?
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• CT scan to review extent of fracture
• xray of lumbar spine due to associated fractures |
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Which bones makes up the ankle?
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tibia, fibula, talus
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What is the Ottawa Ankle Rules?
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• determines whether the patient will need an xray
• if patient meets all the criteria, does not need an xray • 3 components: 1. patient has to be between 18-55 years old 2. able to walk 4 steps at the time of injury and at the time of evaluation 3. no tenderness over the posterior edge of either malleolus |
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What is the Ottawa Foot rules?
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if the patient does not have tenderness at the base of the 5th metatarsal or navicular, you don't have to xray the foot
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What is the most common mechanism of injury for ankle sprains?
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inversion injury
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Which ligaments are sprained in the ankle, from most common to least common?
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1. Anterior talofibular ligament (tears first)
2. Posterior talofibular ligament (tears second) 3. Calcaneofibular ligament (tears last) |
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What additional xrays should be ordered if a patient has a medial malleolar fracture?
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proximal knee xray
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What is Maisonneuve fracture?
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fracture of the proximal fibula with syndesmosis rupture and associated medial malleolus fracture or deltoid ligament rupture
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What is a Tibial Pilon fracture?
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an explosion fracture of the tibia, produced primarily by rotational force
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What is the Thompson test?
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• tests for Achilles Tendon rupture
• squeeze calf and the foot should plantarflex • if plantarflexion does not occur, then Achilles tendon is ruptured |
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What are the 3 types of tibial shaft fractures?
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• Type I - slightly displaced 0-50% and non-comminuted; 90% chance of union
• Type II - >50% displacement, but continued bony contact, may be slightly comminuted, may be open or closed • Type III - complete displacement with comminution, may be open or closed, 70% chance of union |
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What is a tibial plateau fracture?
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a fracture of the proximal articular surface of the tibia
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What is the most common hip dislocation?
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posterior dislocation
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