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9 Cards in this Set
- Front
- Back
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Fractures (In general) |
Types: transverse, spiral, oblique, comminuted and segmental. Open = disruption of skin. Closed = skin is intact. DX: imaging - plain film: both AP and lateral. Radionucleotide bone scan shows increased uptake at site of fx. CT can be better than plain. MRI = study of choice for hip fracture TX: Open, intra-articular, femur, and tibia/fibula fx in adults get analgesics, immobilization and emergent referral. Open - debride, irrigate, if bleeding always consider it open. IV ATB should be given before/after surgery. DOC = 2nd gen cephalosporins or aminoglycosides. Immobilize and fixate. If fx is simple with tibia/fibula, then cast it, if not --> ORIF. CHILDREN: fx more localized to growth plate --> Salter Harris classification system. Torus fx = buckle fx --> cast it for 4-6 wks. |
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Dislocations (In General) |
Dislocation = loss of congruity bw surfaces of joint. Subluxation = less serious than above. Common sites = ant shoulder, post hip, and post elbow. TX: closed reduction. Dislocations that reduce spontaneously immobilize for 2-4 wks followed by ROM. If associated with fx and/or soft tissue, then ORIF. Assess neurovascular status pre and post surgery. |
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Strain/Sprain (In general) |
Strain - injury to bone-tendon unit. Sprain - injury to ligaments/tendons. cause: sudden stretching. Can cause mallet finger - avulsion of terminal extensor tendon (splint for 6 wks). ATL = MC ligament involved in ankle sprain. TX: RICE |
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Shoulder Dislocation |
Cause: falling on outstretched hand - MC = anterior. S/S: pt supporting extremity with other arm. Loss of shoulder contour with elbow pointing outward. DX: AP and thoracic "Y" views. Bankart lesion = tear in labrum can be seen on MRI. TX: Reduction and immobilize with sling and swath. Get post-reduction films. |
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Fractured Clavicle |
what: MC fx in kids and adolescents. Cause: Fall on outstretched arm or birthing. s/s: visible deformity, arm supported by other UE. DX: AP film TX: kids - figure 8 sling 4-6 wks. adults - sling for 6 wks. |
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Acromioclavicular Separation |
AKA separated shoulder What: tearing of AC or CC ligaments via fall on tip of shoulder. S/S: step-off of AC joint. DX: AP of both shoulders - may need pt to hold wt to observe. TX: Mild- moderate --> sling. Severe - operate. |
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Humeral Head Fractures |
who: older pts with osteoporosis S/S: pain, swelling, tenderness of greater tuberosity. Bruising if 24-48 hrs old.Pt holds extremity against chest wall. DX: AP, lateral and Y views. Classified using Neer's TX: closed reduction with sling and swath. Early mobilization and pendulum exercise to prevent frozen shoulder. |
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Humeral Shaft Fracture |
cause: MVC, fall on outstreched hand, or penetrating injury. S/S: pain, swelling, deformity, and shortening. DX: AP and Lat views of elbow and shoulder TX: coaptation splint 1st followed by hanging cast. |
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Supracondylar Humerus Fracture |
cause: fall on outstretched hand with hyperextension of elbow. S/S: pain with swelling DX: AP and Lat views TX: Closed reduction with posterior splint application for displaced fx in kids. Adults - ORIF. |
