• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/51

Click to flip

51 Cards in this Set

  • Front
  • Back
At least how many views are necessary to confirm the diagnosis of a fracture?
At least two.
Are obliqure views used to evaluate fracture fragment relationships?
No--need functional views (angle and base of gait).
Describe a spiral fracture
Fracture is spiral in realtion to the longitudinal axis of the bone. The fracture line is usually at least 2 times longer than the transvers diameter of the bone in the central area of the fractue.
What patient population does one usually see greenstic or torus fractures?
Pediatric population -- where the individual has not yet achieved full growth.
Is there a difference between stress fractures and pathologic fractures? discuss
Pathologic fracture occurs in bone that has been weakended by a disease process. Stress fracture occurs in normal bone due ot overuse or microtrauma.
Describe a comminuted fracture.
At least 3 fragments must be present for a fracture to be classified as comminuted. More than one fracture line exists in on ebone.
Does fracture location in cancellous versus cortical bone affect healing? Discuss.
Yes Cancellus has a better healing potential -- has better osteogenic properties, large fracture surfacees, good soft tissue support, good vascularization and good inherent stability compared to cortical bone.
Describe the circumstances needed for primary bone healing.
Possible only with rigid internal fixation and excellent anatomical position.
What type of healing would one see external bone callus formation, primary or secondary?
secondary.
What relationships must one describe whne describing a fracture?
Lenght, location, angulation rotation, dispalcement, articular nature, stability, and direction fracture line>
What is closed reduction?
manipulation of fracture fragments into nromal alignment wiohut the use of surgical incision.
Describe the mechanism performed for closed reduction.
Increase the deformity, distract the fragments and revers the deformity.
What is the purpose of increasing the deformity when performing closed reduction?
Allows for soft tissue that is interposed between the fragments to be re released.
Patient presents with a crush injury to the 2nd toe. A subungual hematoma is noted. X-ray reveals a transverse fracture of the distal phalanx. What is your next step in the treatment/evaluation of this patient?
Nail bed must bexamined for possibility of lacertion. (Remove nail plate)
The anil plate is removed in btiernt with crush injury to 2nd ote. A 0.5 cm laceration is noted upon nspection f the nail bed. How would this affect the calssifiation and tratment of this pateint?
this is now considered and open fracture. Will need loca wound care,, tetanus prophylaix and systemic antibiotic therapy.
Injuries involving nail bed tissue loss are caegorized according to what as described by rosenthanl
lvel of injury (zones) and direction of tissue loss.
describe the zones in the rosenthal clasification for nail bed tissue loss and distal digital tip injuries.
zone I is distal to distal panx, zone II is distal to lunula and zone III, is porximal to distal endo flunula
list the dirctions of nail bed tissue loss.
dorsal oblique, transvers, plantar oblique, axial and cntral/gougin
secondary intentio healing would be a viable tratment option for which resenthal zone of injury
zone I
What are the 2 most common mechnismms of acute injury to the nail bed and its associated structures?
crushing injry and stubbing forces
a patient presents s/p dropping a book on his great toe and as as a subungual hematoma of 35% of his nail. what is the recommende treatment for theis?
rmove the nail plate and inspec the n ail bed for laceration. As a genarla rule, when greater than 25 to 35% of the nail palt is involved, the above recommended. Less than this can be treated by evatuation of the matomea with a bovei, hot paper cop or other means
which sesamoid is most commonly fracture in the foot?
tibial sesamoid
Is healing usually a problem with a fractured sesamod? why?
yes because it is haghly avascular, htere is a high rate of non-unions
What is the accpeted mechan ism of injry for a 1st mtpj dislocation
hyperextension phrce of the phalanc sesamoid appartus on the metarsa
Describe closed reductionm for a dislocated 1st mtpj.
distraction of toe, exaggerated dorsiflexion followe by force plantarflexory rlocation.
A patient presents with a dislocated 1st MTPJ. Radiographs reveal dorsal dislacatioon o fthe prximal phalanx and and a normal sesamoid to sesamodi relationwhip with both sesamoid dorsal tho the metarsal. What type of reductionm would mostlikely be quequired?
Open reductoin. THe soft tissue aroudn the jointmaintains the postion and closed reduction is vriually impossbil;e for this type ofnjry
Which foot bones hav eth highes ncidence for stress fracture?
2nd metarsal folowed by 3rd metaatarsal
What is the most common fractue type of the 5th metarsal?
avulsion type fractue involving the tuberosity fo the 5th metatarsal (stewart III)
Describ ethe 4location of the true jones fractue?
located at he proximal diaphysis of the 5th metatarsal. It is supra articular
the ligaments that attach the metarsal to the tarasal bones arestronger plantarly or dorsallly?
plantarly.
describe lisfranc's ligament?
interosseous ligament from medial cuneform to 2nd metatrsal base.
Is the following statement true or flase? there i9s no ligamentous attachment from the 1st to the 2nd metatarsal base.
this is true. al the ohter metatrsale are boudn to ne another by a sereis of transvers dorsal and plantar ligaments as well as metarsal liighaments. the one exception is between the 1st and 2nd metarsal bases.
A patient presents with a disloacated 1st MTPJ. Radiographs reveal dorsal dislocation of the proximal phalanx and a normal sedsamoid ot sesamoid relationship with both sesamoids dorsal to the metatarsal. What thype of reduction would most likely be required?
Open reduction. The soft tissue aroudn the hoint maintians the position and clsoed reduction is virtually impossible.
Which foot bones have the hightes incidence for stress fractures?
2nd metatarsal followed byu the 3rd metatarsal
Wht is the most common fracture tyupe of the 5th metatarsal?
avulsion type fracture involving the tuberosity fo the 5th metatarsal (stewardt III)
Describe the location of the true Jones fracture?
lolcated at he proximal diaphysis of the 5th met. It is supra articular
THe ligaments that attach the metarsals to the tarsal bone are stronger plantarly or dorsally
plantarly
Describe Lisfranc's ligament?
Interosseous ligament from medial cuneiform to 2nd metatarsal base.
Is the following statement ture or false? There is no ligamentous attachment form the 1st to wnd met base?
True.
All the other metatarsal sare bound ot one another by a series of transverse dorsal and plantar ligaments as well as a intermetatarsal ligaments. The one xception is between the 1st and 2nd met bases
What is a pathognomic sign of Lisfranc dislocation?
Diastasis between the 1st and 2nd met bases usually with a small avulsion fragment between the 1st and 2nd met bases
If plain radiographs are unequivocal and you still suspect Lisfranc dislocation, what radiologic study would be indicated?
Stress abduction view
Describe the intrinsic stability of Lisfranc's joint.
Tarsometatarsal jints from a bon arc from medial to lateral with extensive ligamentous support and the "keystone" nature of the 2nd metatarsal in which it is recess at its base.
Discuss the Hardcastle classification system for Lisfranc injry.
Type A total incongruity of the entire tarsometatarsal joint.
Type Bpartial incongruity
B1 medial displacemtn affecting the 1st met either alone or in combination of one or more the 2nd, 3rd, 4th mets
B2 is lateral displacemnt of one or more fo the four less mets while ht 1st is unaffected.
C is deivergent displacemnt involving partioal or total incongruity of the joint. C1 parital, C2 toal displacemnt
What are hte town mechanism postulated for tarsometatarsal joint injury?
Direct and indirect. Direct is crushing forse on the dorsum of the foot. Indirect usually with forced forefoot plantarflexion and forefoot abduction of the fot. (can be associated iwth forced forefoot dorsiflexion as well.)
What is the radiogrphic sing tht is a patogonmonic indicator of nonuion/
sclerosis of the fracture ends.
What is th edifference between a delaye dunion and a nonunion?
The difference between these two is a factor of time A nonunion shows no progressive healing at a fracture site after 9 months s/p fracuter while a delayed union is defiend as afracture site in which the healing has not advanced at the average rate fro the loccation and type of fractue.
What are the two baseic categoreis of nonuions seen radiographically?
Atrophic (avascular) and hypertrophic (vascular) hypervascular also divided into elephant foot, horse foot and oligotrphic based o nthe amound of callus formation. Avascular divided into torsion wedge, comminuted, defect adn atrophic
An electric bone stimulator would mostlikely be beneficial for what type of ononuion as a promary form of treatemnt without surgical intervention.
hypertophic (vascular)
How is an atrophic nonunion treated?
surgery to debride the fracture ends and a bone grapft is inserted with fixation. A bone stimmulator can also be applied along with cast immobilization.
What i spseudoarthrosis?
A fosle joint fomed at a fracture site due to continued movement without proper immobilization
What are the four phases in the intial ssessment of a trauma patient?
Primary surve (injuries that threaten life or limb are identified),
resuscitation (life threatening injuries are treated)
secondaryh survey ( a systemic in depth evaluation of the patient from head to toe is performed with continuous reassessment of the pateint's condition)
and definitive care (less serious injuries are managed