Kushner trauma-stuff you know

quickster2008's version from 2016-01-14 03:55


Question Answer
At least how many views are necessary to confirm the diagnosis of a fracture?At least two.
Are oblique views used to evaluate fracture fragment relationships?No need functional views (angle and base of gait).
Describe a spiral fracture?Fracture is spiral in relation to the longitudinal axis of the bone.
What patient population does one usually see greenstick or torus fractures?peds
Is there a difference between a stress fracture and pathologic fracture? Discuss. Pathologic fracture occurs in bone that has been weakened by a disease process. Stress fracture occurs in normal bone due to 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 one bone.
Does fracture location in cancellous versus cortical bone affect healing? Discuss.Yes. Cancellous has a better healing potential has better osteogenic properties, large fracture surfaces, 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 when describing a fractureLength, location, angulation rotation, displacement, articular nature, stability, and direction fracture line.
What is closed reduction?Manipulation of fracture fragments into normal alignment without the use o f surgical incision.
Describe the mechanism performed for closed reduction.Increase the deformity, distract the fragments and reverse 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 released.
Patient presents with a crush injury to the 2nd toe. A subungual hematoma is noted. X-ray reveals a transverse fracture oftbe distal phalanx. What is your next step in the treatment/evaluation ofthis patient'!Nail bed must be examined for possibility of laceration. (Remove nail plate.)
The nail plate is removed in the above patient. A 0.5 cm laceration is noted upon inspection of the nail bed. How would this affect tbe classification and treatment of this patientnow considered open fx.Will need local wound care, tetanus prophylaxis and systemic antibiotic therapy.
Injuries involving nail bed tissue loss are categorized according to what as described by Rosenthal?Level of injury (Zones) and direction oftissue loss.
Describe the zones in the Rosenthal classification for nail bed tissue loss and distal digital tip injuries.Zone I is distal to distal phalanx, zone II is distal to lunula and zone mis proximal to the distal end ofthe lunula.
List the directions of nail bed tissue loss.Dorsal oblique, transverse, plantar oblique, axial and central/gouging.
Secondary intention healing would be a viable treatment option for which Rosenthal zone of injury?zone 1
What are the two most common mechanisms of acute injury to the nail bed and its associated structures?Crushing injury and stubbing forces.
A patient presents sIp dropping a book on his great toe and as a subungual hematoma of 35 %. of his nail. What is the recommended treatment for this? Remove the nail plate(>25%) and inspect the nail bed for laceration.
Which sesamoid is most commonly fractured in the foot?TIBIAL sesamoid
What are the radiographic features evaluated when differentiating a fractured sesamoid from a congenital partite sesamoid?
Is healing usually a problem with a fractured sesamoid? Why?Yes because it is highly avascular. There is a high rate of non-unions
Which foot bones have the highest incidence for stress fractures'?2nd metatarsal followed by the 3rd metatarsal.
What is the most common fracture type of the 5th metatarsal?Avulsion type fracture involving the tuberosity ofthe 5th metatarsal (Stewart lJI).
The ligaments that attach the metatarsals to the tarsal bones are stronger plantarly or dorsally? Plantarly.
Describe Lisfranc's ligament?Interosseous ligament from medial cuneiform to 2nd metatarsal base.
Which lateral collateral ligaments are extra-capsular?Calcaneofibular.
Is the following statement true or false? There is no ligamentous attachment from tbe 1'1 to 2nd metatarsal base.true. All the other metatarsals are bound to one another by a series of transverse dorsal and plantar ligaments as well as intermetatarsal ligaments. The one exception is between the Ist and 2nd metatarsal bases.
What is a pathognomonic sign of Lisfrane dislocation?Diastasis between the 1S[ and 2nd metatarsal bases usually with a small avulsion fragment between the 1st and 2nd met bases.
Discuss the Hardcastle classitication system for Lisfranc injury.
Patient presents with blistering wounds on the dorsum of her foot after spilling a cup of hot coffee on her foot. Classify this burn and describe the extent ofthe injury involved.These are 2nd degree bums. These are partial thickness affecting the epidermis and dermis but not penetrating through the basement membrane.
Wbat is tbe Danis-Weber classification system based on?Anatomical position of the fibular fracture fragment in relation to the distal syndesmosis.
Wagstaffe fracture would be seen in what stage of a supination eversion (external rotation) injury?Stage 1
Radiographs reveal a spiral fracture of the fibula starting at the distal syndesmosis and a transverse fracture of medial malleolus. Classify this injury (Lauge Hansen) Supination-external rotation Stage IV.
What is Volkmann's fractureAvulsion fracture o f the posterior malleolus.
What stage injury is present if Maisonneuve fracture is noted?PER 3.