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345 Cards in this Set

  • Front
  • Back

Other name for an open fracture

Compound fracture

What happens with an open fracture after 6 hours

It's considered infected

What is the classification for open fracture

Gustillo and Anderson

Gustillo type 1

Less than 1cm


Clean


Bone graft can be done immediately

Gustillo type 2

Greater than 1cm


Clean


Bone graft at delayed primary closure

Gustillo type 2

Greater than 1cm


Clean


Bone graft at delayed primary closure

Gustillo type 3 a,b,c

Extensive open wound


Dirty


Bone graft when bone callus diminishes




Type 3a soft tissue coverage


Type 3b not enough coverage


Type 3c vascular damage

Treatment for compound fracture

Culture and sensitivity


Wound debridement/irrigation


Fracture stabilization


Tetanus prophylaxis


IV ancef 1-2 g followed by 1g q8 until cultures arrive

Treatment for compound fracture

Culture and sensitivity


Wound debridement/irrigation


Fracture stabilization


Tetanus prophylaxis


IV ancef 1-2 g followed by 1g q8 until cultures arrive

Fluorescein can be used for __________ evaluation in open fractures

Vascular

Treatment for compound fracture

Culture and sensitivity


Wound debridement/irrigation


Fracture stabilization


Tetanus prophylaxis


IV ancef 1-2 g followed by 1g q8 until cultures arrive

Fluorescein can be used for __________ evaluation in open fractures

Vascular

Where is the most notable area of stress fracture in foot

Neck of 2nd met

How long can it take for a stress fracture to show up on x-ray

2 weeks

How long can it take for a stress fracture to show up on x-ray

2-3 weeks

Stress fracture can show up on bone scan as early as

2-8 days

An incomplete fracture of only 1 cortex is known as

Greenstick fracture

An incomplete fracture of only 1 cortex is known as

Greenstick fracture

Greenstick fractures are seen in

Children

Injury to the MPJ caused by excessive extension

Turf toe

Injury to the MPJ caused by excessive extension

Turf toe

Turf toe result in injury to

Ligaments and plantar capsule

What is the classification for MPJ injuries

JAHSS

What is the classification for MPJ injuries

JAHSS

JAHSS type 1a

Dorsal dislocation of proximal phalanx



Met head intrasesamoid ligament

What is the classification for MPJ injuries

JAHSS

JAHSS type 1a

Dorsal dislocation of proximal phalanx



Met head intrasesamoid ligament

JAHSS Type 2a

Dorsal dislocation of proximal phalanx



Met head tears through intrasesamoidal ligament

What is the classification for MPJ injuries

JAHSS

JAHSS type 1a

Dorsal dislocation of proximal phalanx



Met head intrasesamoid ligament

JAHSS Type 2a

Dorsal dislocation of proximal phalanx



Met head tears through intrasesamoidal ligament

JAHSS type 2b

Dorsal dislocation of proximal phalanx on met



Met head causes avulsion fracture of sesamoid

What is the classification for MPJ injuries

JAHSS

JAHSS type 1a

Dorsal dislocation of proximal phalanx



Met head intrasesamoid ligament

JAHSS Type 2a

Dorsal dislocation of proximal phalanx



Met head tears through intrasesamoidal ligament

JAHSS type 2b

Dorsal dislocation of proximal phalanx on met



Met head causes avulsion fracture of sesamoid

Which JAHSS is easier to reduce

Type IIa



That tears intrasesamoid ligament

Sesamoid fracture must be distinguished from

Bipartite sesamoid

Complications of sesamoid removal



Fibular sesamoid


Tibial sesamoid


Both sesamoids

Hallux varus


Hallux valgus


Hallux malleus

Sesamoid fracture must be distinguished from

Bipartite sesamoid

Complications of sesamoid removal



Fibular sesamoid


Tibial sesamoid


Both sesamoids

Hallux varus


Hallux valgus


Hallux malleus

Correction for hallux malleus

Jones tenosuspension


hallux ipj fusion

Most common method of ankle injury

Inversion, plantarflexion

Most common method of ankle injury

Inversion, plantarflexion

Inversion dorsiflexion ankle sprain will damage

Calcaneofibular

Dorsiflexion inversion injury will damage

Calcaneofibular ligament

Arthrograms are useful in acute or chronic ankle sprains?

Acute sprains while ligaments are still damaged

Arthrograms are useful in acute or chronic ankle sprains?

Acute sprains while ligaments are still damaged

Oreo cookie sign

Radiolucent ankle articular cartilage with radiopaque die between

Anterior drawer for ankle is used to test

ATF



8mm of excursion positive

Stress inversion test for ankle inversion injury tests

Calcaneofibular ligament



Taker till greater than 5* indicates injury

Everersion sprain


Schoolfields procedure

Advances deltoid ligament

Everersion sprain


Schoolfields procedure

Advances deltoid ligament

Eversion sprain


Duvries

Cruciate incision in deltoid then sutured together

Everersion sprain


Schoolfields procedure

Advances deltoid ligament

Eversion sprain


Duvries

Cruciate incision in deltoid then sutured together

Surgery for inversion sprains

Brostrum procedure

Bosworth fx

Lateral malleolus

Cotton fx

Tri malleolar

Potts fx

Bi malleolar

Maisonneuve fx

High fibular

Tillaux chaput fx

Avulsion Anterior inferior lateral tibia

Wagstaffe fx

Anterior medial inferior fibula

Potts fx

Bi malleolar

Maisonneuve fx

High fibular

Tillaux chaput fx

Avulsion Anterior inferior lateral tibia

Wagstaffe fx

Anterior medial inferior fibula

Volkmann fx

Posterior malleolus

Lauge Hansen is a classification for

Ankle fractures

Lauge Hansen

SAD - supination adduction



SER - supination external rotation



PAB - pronation abduction



PER - pronation external rotation

Lauge Hansen is based on the

Fibula

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

What is the key to restore in ankle fracture management

Fibula

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

What is the key to restore in ankle fracture management

Fibula

What is the most common lauge Hansen is

SER 2

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

What is the key to restore in ankle fracture management

Fibula

What is the most common lauge Hansen is

SER 2

What is the mechanism of injury that pt says for SER 2

I sat on my ankle

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

What is the key to restore in ankle fracture management

Fibula

What is the most common lauge Hansen is

SER 2

What is the mechanism of injury that pt says for SER 2

I sat on my ankle

What is the worst ankle fracture in Lauge hansen

PER 3

Lauge Hansen is based on the

Fibula

Intact ligament means

Bone fracture

Ruptured ligament means

Intact bone

Which has a better prognosis



Avulsion or ruptured ligament

Avulsion/fracture

What is the key to restore in ankle fracture management

Fibula

What is the most common lauge Hansen is

SER 2

What is the mechanism of injury that pt says for SER 2

I sat on my ankle

What is the worst ankle fracture in Lauge hansen

PER 3

What is the mechanism of action pt says with with PER 3

Moving forward and catches weight moving forward snapping ankle

What is a SER 2

Spiral oblique fracture of fibula at level of ankle joint

What is a PER 3

High fibular neck fracture


(Maissoneve)

Unique fracture patterns of lauge Hansen



SAD 1, 2


PAB 3


SER 2


PER 3

SAD 1 - transverse fibula


SAD 2 - vertical tibia



PAB 3 - short oblique, butterfly


fibula



SER 2 - long oblique fibula



PER 3 - high fibula

Short oblique fracture will look oblique on Lateral but on AP will will look

Transverse

Danis Weber ankle classification is based on

Fibula

Danis Weber



And corresponding Lauge Hansen

Type A - below syndesmosis


SAD



Type B - at syndesmosis


SER



Type C - Above syndesmosis


PER

Classification for epiphyseal plate fractures

Salter-harris

Classification for epiphyseal plate fractures

Salter-harris

Salter-harris classification

Type 1 - same


Type 2 - above


Type 3 - lower


Type 4 - through


Type 5 - compression


Type 6 - rate bite


Type 7 -

Classification for epiphyseal plate fractures

Salter-harris

Salter-harris classification

Type 1 - same


Type 2 - above


Type 3 - lower


Type 4 - through


Type 5 - compression


Type 6 - rate bite


Type 7 -

Osteochondritis dissecans =

Talar dome fx

Classification for epiphyseal plate fractures

Salter-harris

Salter-harris classification

Type 1 - same


Type 2 - above


Type 3 - lower


Type 4 - through


Type 5 - compression


Type 6 - rate bite


Type 7 -

Osteochondritis dissecans =

Talar dome fx

What are the common locations for Talar dome fractures

DIAL a PIMP

Anterior lateral Talar dome fractures



are what shape



Caused by

Wafer shaped



Trauma

Anterior lateral Talar dome fractures



are what shape



Caused by

Wafer shaped



Trauma

Posterior medial Talar dome fractures are what shape

Deep cup



Not trauma

Anterior lateral Talar dome fractures



are what shape



Caused by

Wafer shaped



Trauma

Posterior medial Talar dome fractures are what shape

Deep cup



Not trauma

Classification for Talar dome fractures

Berndt- hardy

Berndt hardy

Type 1compression


Type 2 partial detached


Type 3 full detached but still in


Type 4 full detached and out

Berndt hardy

Type 1compression


Type 2 partial detached


Type 3 full detached but still in


Type 4 full detached and out

Talar dome lesion treatment

NWB cast


Type 1, Type 2, Type 3 medial



Surgery


Type 3 lateral, Type 4

Fracture of posterior process of talus

Steida's process



Shepards fx

Fracture of posterior process of talus

Steida's process



Shepards fx

Which tubercle is involved in shepards fx

Lateral

What is the mechanism of injury in shepards fx

Forced plantar flexion


Dorsiflexion cause avulsion with talofibular ligament

What is the test for shepards fx

Plantarflex foot and dorsiflex hallux

Nutcracker sign is

Pain with forced plantarflexion

Is shepards fracture caused by plantar flexion or dorsi flexion

Both

Front (Term)

Jones fracture


Avulsion fracture

Classification for 5th met fractures

Torg

Jones fracture


Avulsion fracture

Classification for 5th met fractures

Torg

Torg type 1

Acute jones

Front (Term)


Hj

He Back (Definition)

Torg type 3

Non union jones

Torg type 2

Delayed Union jones

Pilon fracture classification

Ruedi and Allgower

Pilon fracture classification

Ruedi and Allgower

Ruedi allgower

Type 1 - distal tibia fracture no displacement



Type 2 - distal tibia fracture with displacement



Type 3 - distal tibia fracture with displacement and comminution

Pilon fracture classification

Ruedi and Allgower

Ruedi allgower

Type 1 - distal tibia fracture no displacement



Type 2 - distal tibia fracture with displacement



Type 3 - distal tibia fracture with displacement and comminution

What is the most common type of Hard castle lis franc injury

Type A total/homolateral

Pilon fracture classification

Ruedi and Allgower

Ruedi allgower

Type 1 - distal tibia fracture no displacement



Type 2 - distal tibia fracture with displacement



Type 3 - distal tibia fracture with displacement and comminution

What is the most common type of Hard castle lis franc injury

Type A total/homolateral

Hardcastle

Type A homolateral


A1 homolateral


A2 homomedial



Type B partial


B1 1st met medial


B2 lesser mets lateral



Type C divergent


C1 met 1 medial and


met 2 lateral


C2 met 1 medial and


lesser mets lateral

Classification for navicular fractures

Watson jones

Classification for navicular fractures

Watson jones

Watson jones classification

Type 1 - navicular tuberosity


Type 2 - navicular dorsal lip


Type 3 - navicular body


Type 4 - stress fracture

Classification for navicular fractures

Watson jones

Watson jones classification

Type 1 - navicular tuberosity


Type 2 - navicular dorsal lip


Type 3 - navicular body


Type 4 - stress fracture

Watson jones type 1 is associated with what other fracture

Nutcracker fracture of cuboid

Achilles inserts to

Middle 1/3 of posterior aspect of calcaneal tuberosity

Achilles inserts to

Middle 1/3 of posterior aspect of calcaneal tuberosity

Area of Achilles rupture

Poor blood supply



2-6 cm proximal to insertion

Is active plantarflexion still possible after complete Achilles rupture

Yes

Is active plantarflexion still possible after complete Achilles rupture

Yes

Often after a complete Achilles rupture which muscle tendon will remain intact

Plantaris

Is active plantarflexion still possible after complete Achilles rupture

Yes

Often after a complete Achilles rupture which muscle tendon will remain intact

Plantaris

Thompson test

Squeeze calf to see if there's plantarflexion



No plantarflexion = rupture

Kagers triangle

Should be clear



If ATR there will be increased soft tissue density in triangle

Toyger's angle

Like drawn down posterior aspect of Achilles should be 180



With Achilles rupture this angle decreases

Borders of kagers triangle

Achilles


Calcaneus


FHL

What can be felt in a ruptured Achilles

Palpable dell

Conservative treatment for Achilles' tendon rupture

NWB equinus cast



Equinus reduced every 2 weeks

After surgery of Achilles' tendon rupture pt is casted in what position

Equinus

The following are procedures for



Bosworth


Bugg and boyd


Lindholm


Peroneus brevis tendon

Achilles' tendon rupture

What is the sport most associated with peroneal injuries

Skiiing

What is the sport most associated with peroneal injuries

Skiiing

With peroneal subluxation/dislocation what sign may be seen on ankle Mortise parallel with lateral malleolus

Fleck sign

Which peroneal is most likely to dislocate

Peroneus longus

What is the sport most associated with peroneal injuries

Skiiing

With peroneal subluxation/dislocation what sign may be seen on ankle Mortise parallel with lateral malleolus

Fleck sign

Which peroneal is most likely to dislocate

Peroneus longus

Classification for peroneal/subluxation

Eckert & Davis

What is the sport most associated with peroneal injuries

Skiiing

With peroneal subluxation/dislocation what sign may be seen on ankle Mortise parallel with lateral malleolus

Fleck sign

Which peroneal is most likely to dislocate

Peroneus longus

Classification for peroneal/subluxation

Eckert & Davis

Which eckert and Davis classification is most common

Grade 1

What is the sport most associated with peroneal injuries

Skiiing

With peroneal subluxation/dislocation what sign may be seen on ankle Mortise parallel with lateral malleolus

Fleck sign

Which peroneal is most likely to dislocate

Peroneus longus

Classification for peroneal/subluxation

Eckert & Davis

Which eckert and Davis classification is most common

Grade 1

Which eckert and davis classification has a bony avulsion

Grade 3

Treatment for peroneal subluxation

Retinacular repair with Achilles slip augmentation



Deepen fibular groove



Sagitally cut to fibula and move proximally

Snowboards fracture

Lateral process of talus

Treatment for peroneal subluxation

Retinacular repair with Achilles slip augmentation



Deepen fibular groove



Sagitally cut to fibula and move proximally

Snowboards fracture

Lateral process of talus

Footballers injury or plié can cause

Anterior ankle impingement

Treatment for peroneal subluxation

Retinacular repair with Achilles slip augmentation



Deepen fibular groove



Sagitally cut to fibula and move proximally

Snowboards fracture

Lateral process of talus

Footballers injury or plié can cause

Anterior ankle impingement

Dancers tendinitis

FHL tendinitis

Where do tibialis posterior ruptures occur

Lowest vascularity behind medial malleolus

Where do tibialis posterior ruptures occur

Lowest vascularity behind medial malleolus

When tibialis posterior tendon ruptured pts may see what change in foot structure

Longitudinal arch falls

Test to see if Tibialis posterior is ruptured

Raise on toes and see if heel inverts

Which tendon can be used to reinforce ruptured tibialis posterior

Flexor digitorum longus

Which tendon can be used to reinforce ruptured tibialis posterior

Flexor digitorum longus

When the FDL proximal part is used to reinforce tibialis posterior, the distal part is sutured to

FHL

Which tendon can be used to reinforce ruptured tibialis posterior

Flexor digitorum longus

When the FDL proximal part is used to reinforce tibialis posterior, the distal part is sutured to

FHL

Classification for PTTD

Johnson and strom

Which tendon can be used to reinforce ruptured tibialis posterior

Flexor digitorum longus

When the FDL proximal part is used to reinforce tibialis posterior, the distal part is sutured to

FHL

Classification for PTTD

Johnson and strom

Johnson and strom stage 1

Normal tendon length, mild degeneration

Which tendon can be used to reinforce ruptured tibialis posterior

Flexor digitorum longus

When the FDL proximal part is used to reinforce tibialis posterior, the distal part is sutured to

FHL

Classification for PTTD

Johnson and strom

Johnson and strom


stage 1

Normal tendon length, mild degeneration

Johnson and strom


Stage 2

Tendon elongation, marked degeneration

Johnson and strom


Stage 3

Tendon elongation, fixed valgus hind foot

Johnson and strom


Stage 4

Stage 3 plus lateral ankle pain and instability

Johnson and strom


Stage 4

Stage 3 plus lateral ankle pain and instability

Johnson and strom stage II is associated with

Flexible acquired pea planovalgus

Johnson and strom


Stage 4

Stage 3 plus lateral ankle pain and instability

Johnson and strom stage II is associated with

Flexible acquired pea planovalgus

If FDL is not available for tibialis posterior tendon repair, can use

Tibialis anterior

Johnson and strom


Stage 4

Stage 3 plus lateral ankle pain and instability

Johnson and strom stage II is associated with

Flexible acquired pea planovalgus

If FDL is not available for tibialis posterior tendon repair, can use

Tibialis anterior

Most common complication of arthroeresis

Sinus tarsitus

Signs of tibialis anterior rupture

Decreased dorsiflexion


Steppage gait, foot drop

At 95*

Patient unaware of 1/3 of events around them

At 95*

Patient unaware of 1/3 of events around them

Loss of shivering occurs at

87.8*

During hypothermia advanced life support should continue until pt is rewarded to

95* F



35* C

During rewarming of hypothermia pt what effect can happen

Afterdrop



Drop in core temperature

During rewarming of hypothermia pt what effect can happen

Afterdrop



Drop in core temperature

Methods of rewarming pt

Passive


Active external


Active core

During rewarming of hypothermia pt what effect can happen

Afterdrop



Drop in core temperature

Methods of rewarming pt

Passive


Active external


Active core

Warm environment and blankets are example of what treatment in hypothermia

Passive

Injury to tissue due to freezing

Frostbite

Injury to tissue due to freezing

Frostbite

Cellular damage in frostbite occurs from

Direct injury (ice)



And ischemia

Injury to tissue due to freezing

Frostbite

Cellular damage in frostbite occurs from

Direct injury (ice)



And ischemia

If there is frostbite with continued risk for re-freezing the part should

Not be thawed

Frostbite


1st degree

No blistering

Frostbite


2nd degree

Blistering

Frostbite


3rd degree

Death of skin

Frostbite


3rd degree

Death of skin

Frostbite


4th degree

Full thickness


Loss of body part

How can superficial frostbite (frostnip) be rewarmed

Place warm hands or on other warm body part

How can superficial frostbite (frostnip) be rewarmed

Place warm hands or on other warm body part

When rewarming from frostbite pt might need

Analgesics

Best method for treating full thickness frostbite

Rapid thawing at just above body temperature for 30 minutes

Best method for treating full thickness frostbite

Rapid thawing at just above body temperature for 30 minutes

Should you massage frostbite area

No

Best method for treating full thickness frostbite

Rapid thawing at just above body temperature for 30 minutes

Should you massage frostbite area

No

When is amputation done in frostbite

When there's visible line of demarcation

Best method for treating full thickness frostbite

Rapid thawing at just above body temperature for 30 minutes

Should you massage frostbite area

No

When is amputation done in frostbite

When there's visible line of demarcation

Should extreme heat be used in frostbite

No

A recurrent localized skin lesion resulting from cold humid environments

Chillblains (pernio)

A recurrent localized skin lesion resulting from cold humid environments

Chillblains (pernio)

Caused by prolonged immersion in cool or cold water

Trench foot (immersion foot)

Trench foot is treated by

Elevating limb and rewarming it

The basis of hypothermia is

Dehydration

The basis of hypothermia is

Dehydration

At 90*

Heart and lungs begin to fail

In trench foot pulses are ________ but as rewarm pulses are ________

Bounding



Normal

In trench foot pulses are ________ but as rewarm pulses are ________

Bounding



Normal

Hypothermia is at

95*

Escharotomy may be indicated in

Burns

Rule of 9s

Used to estimated burn % of body

Rule of 9s

Used to estimated burn % of body

Rule of palm

1hand = 1.25% Burn percent



1 foot = 3.5%

1st degree and 2nd degree burns are

Partial thickness

1st degree and 2nd degree burns are

Partial thickness

3rd degree burns are

Full thickness

1st degree and 2nd degree burns are

Partial thickness

3rd degree burns are

Full thickness

1st degree burn involves

Epidermis

1st degree and 2nd degree burns are

Partial thickness

3rd degree burns are

Full thickness

1st degree burn involves

Epidermis

2nd degree burn involves

Dermis

1st degree and 2nd degree burns are

Partial thickness

3rd degree burns are

Full thickness

1st degree burn involves

Epidermis

2nd degree burn involves

Dermis

3rd degree burn

Goes through dermis

How can you shorten period of burn progression

Cool water

Might tetanus prophylaxis be needed for burns

Yes

Animal responsible for most bites

Dog

Do more cat bites or dog bites become infected

Cat

What is the most common organism in cat bites

Pasteurella multocida

How fast do pasturella infections advance

Within 24 hours

How fast do pasturella infections advance

Within 24 hours

Cat scratch fever is caused by

Bartonella

How fast do pasturella infections advance

Within 24 hours

Cat scratch fever is caused by

Bartonella

In human bites there is a higher number of __________ organisms

Anaerobic

How fast do pasturella infections advance

Within 24 hours

Cat scratch fever is caused by

Bartonella

In human bites there is a higher number of __________ organisms than in other bites

Anaerobic

Eikenella may be seen in ______ bites

Human

What is the treatment choice for bites

Penicillin



Augmentin 500 mg PO TID

What is the treatment choice for bites

Penicillin



Augmentin 500 mg PO TID

If bitten by a household pet is rabies shot required

No, observation for 10 days unless animal develops rabies

What is the treatment choice for bites

Penicillin



Augmentin 500 mg PO TID

If bitten by a household pet is rabies shot required

No, observation for 10 days unless animal develops rabies

For other animal bites, what should you do about rabies

Contact local health department above prevalence of rabies in that animal

Puncture wounds resulting in cellulitis caused by

Staph aureus

Puncture wounds causing osteomyelitis are caused by

Pseduomonas

Scarring after compartment syndrome can cause

Volkmanns contractures

Scarring after compartment syndrome can cause

Volkmanns contractures

Puncture involving soil

Clostridium

Above how many mmHG do consider surgery for compartment surgery

30 mmHg

Above how many mmHG do consider surgery for compartment surgery

30 mmHg

Are pulses intact in compartment syndrome

Yes

Can a tight cast cause compartment syndrome

Yes

Fracture in foot that can cause compartment syndrome

Calcaneal

Are incisions for compartment syndrome fasciotomy closed

No, Left open for 5 days

Medial compartment muscles

ABH


FHL tendon


FHB

Lateral compartment

Flexor digiti minimi


Abductor digiti minimi

Central compartment muscles

FDB


Lumbricales


Quadratus plantae


Adductor hallucis



Tendons of


FDL


PT


Peroneal longus

Interosseous compartment muscles

4 dorsal interossei


3 plantar interossei