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27 Cards in this Set
- Front
- Back
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Nightstick Fx
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Ulna
Direct blow Tx: Long arm cast |
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Humeral Shaft Fx
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Proximal Humerus
Open/Closed Direct blow, fall, or MVA Tx: cast brasing or ORIF ***radial n. injury is common*** |
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Intercondylar -T -Y Fx
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Distal end of Humerus
Fall on outstretched hand Tx: ORIF, TEA, Replacement (depends on type) |
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Classification of Intercondylar -T -Y Fx
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1: Non-displaced
2: Minimal separation 3: Rotation of fragments 4: Comminuted/Butterfly |
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Radial Head Fx
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Proximal Radius
Fall on outstretched hand Tx: long arm cast-90 deg or ORIF (depends on type) ***anterior fat pad present*** |
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Types of Radial Head Fx
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1: non displaced (<2mm)
2: displaced with large fragment (ORIF) 3: comminuted (ORIF w/ replacement of radial head) 4: associated with dislocation |
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Bennet Fx
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Fx dislocation of thumb. At basal joint, fragment of the metacarpal is pulled off by oblique ligamanet
Fist fights Tx: thumb spica, IP joint free, wrist at 30 deg |
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Boxer's Fx
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Distal 4th/5th metacarpal
Punching a solid object/wall Tx: Ulnar gutter splint, metacarpals at 70-90 deg flex ***if open: direct surgical referral*** |
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Scaphoid Fx
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Scaphoid bone Fx ("snuffbox" is the middle section)
Fall on outstretched hand-axial compression/hyperext. Tx: Short arm thumb spica ***most commonly fractured bone*** ***risk of avscular necrosis*** |
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Mallet Finger
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Fx and tendon disruption at DIP joint
Blow to the tip of the finger causing flexion Tx: splint DIP joint |
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Avulsion
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Tearing of tendon
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Jersey Finger
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Rupture of distal flexor tendon, possible fx as well
Forceful hypertextension from pulling a jersey Typically the 4th digit Tx: splint PIP and DIP slightly flexed |
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Femoral Neck Fx
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"Broke my hip"
Falling sideways onto hip Tx: internal fixation (not ORIF) ***risk of avascular necrosis*** ***complication of DVT*** |
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Subtrochanteric Femoral Head Fx
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Between lesser trochanter and pt 5 cm distal
MC due to pathologic cause Tx: internal fixation (open or closed) ***malunion and non-union common*** |
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Diaphysial Fx
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Between 5 cm distal to lesser trochanter and 5 cm proximal to the adductor tubercle
Tx: Gold standard- reamed, locked, antegrade intramedullary nail through piriformis fossa ***presentation- soft tissue injury, excessive bleeding, shock, pain, and deformity*** |
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Patellar Fx-Transverse
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Patella fx in transverse plane
Direct blow with knee in flexion Clinical- swelling of ant knee, str knee may be preserved Tx: Walking cylinder cast ***severe hemarthrosis common*** |
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Patellar Fx- Comminuted
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Patella broken into many pieces
MVA Tx: ORIF with cerclage wire ***severe hemarthrosis common*** |
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Knee dislocation
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Ligamentous injury
Popliteal A. Peroneal N. Order arteriogram |
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Tibia Fractures
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Usually lateral tibia plateau fractures
Axial loading with varus/valgus force Tx: functional brace ***meniscal and ligament tearing common*** |
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Tibia and Fibula Fx
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Both bones broken-open or closed
Direct trauma or torsional stress Tx: fasciotomy, brace, casting ***complication: inf, malunion, nonunion, pain*** |
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Compartment Syndrome
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Tibia fractures
Pressure in any of the close osteofascial spaces Circulation is compromised Fasciotomy relieves pressure |
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Jones Fx
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Foot Fx
Metaphysial/diaphysial area of 5th metatarsal Forced inversion of foot/ankle (basketball landing) Tx: walking boot and RICE |
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Tilleaux Fx
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Pediatric Fx!
Distal ankle/tibia Displacement of bone from growth plate Tx: depends on Salter-Harris (I&II air cast and crutches) (III, IV, V ortho consult-often open) |
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3 Peds Pearls
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Comparison View
Fx cross the growth plate? Check Salter-Harris Look for red flags of abuse |
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Clavicle Fx
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Very common
Distal 1/3 of clavicle Due to fall on the shoulder Tx: RICE and Sling |
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Child Abuse Injuries
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Subracondylar humerus
Rib Fx Sternum, scapula, spinous processes Multiple Fx in various stages of healing Skull Fx <18 months |
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Hip Vascular Supply
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Retinacular Vessels
Interosseous Circulation Ligamentum Teres A. |
