Orthopedic Fractures and Dislocations

These flashcards cover essential concepts related to orthopedic fractures and dislocations, including signs, symptoms, management strategies, and definitions relevant for examination preparation.

What are common signs of a base of the skull fracture?

Signs include CSF rhinorrhea, CSF otorrhea, raccoon eyes, and battle sign.

What are Femoral Neck Fractures?

Femoral neck fractures are common in the elderly, often due to osteoporosis following a low-energy fall. They are split into three main types: subcapital (intracapsular), intertrochanteric (extracapsular), and stress fractures. Management strategies vary based on patient age, fracture severity, and underlying bone quality.

What is the management for a malar fracture?

Management includes ruling out head injuries and possible surgical intervention if the fracture is displaced.

What characterizes a stable thoracolumbar fracture?

A compression fracture with less than 50% loss of height.

What is the first step in managing any thoracolumbar fracture?

Providing analgesia for pain relief.

What is the presentation of a clavicular fracture?

Extreme shoulder pain, arm supported at the elbow, and potential neurovascular injury.

How is a displaced clavicular fracture treated?

A displaced clavicular fracture typically requires open reduction and internal fixation (ORIF) when the displacement is significant, commonly defined as >2 cm, or if there is 100\% displacement leading to non-union. Surgical fixation methods often include plates and screws to restore anatomical alignment and stability. This intervention aims to prevent malunion, reduce pain, and improve shoulder function.

What is the key concern with a supracondylar fracture in children?

Risk of brachial artery injury and potential compartment syndrome.

How is a scaphoid fracture diagnosed even if initial X-rays are normal?

Through immobilization in a scaphoid plaster and repeat imaging after 10 days.

What is Collie's fracture and how does it present?

A distal radius fracture presenting with a 'dinner fork' deformity, caused by a fall on an outstretched hand.

What is the primary treatment for a metacarpal fracture?

Reduction and splinting with a padded posterior plaster slab.

What is the typical healing duration for tibial shaft fractures?

Tibial shaft fractures can take 16 to 18 weeks to heal.

What are red flags in a patient with low back pain?

Age over 50, history of cancer, unexplained weight loss, bowel or bladder incontinence, and new or progressive loss of sensation.

What is the first-line treatment for mechanical low back pain?

Analgesics, primarily paracetamol.

What defines radiculopathy?

Nerve root compression causing tingling and numbness in a specific dermatome.

What differentiates mechanical pain from inflammatory pain?

Mechanical pain improves with rest and worsens with activity, while inflammatory pain worsens with rest and improves with activity.

What imaging is primarily used for suspected cervical or lumbar radiculopathy?

MRI is the most appropriate imaging if symptoms persist.

What condition is characterized by numbness, tingling, and upper motor neuron signs due to spinal cord compression?

Myelopathy.

What initial treatments are typically used for adhesive capsulitis (frozen shoulder)?

Analgesics and physiotherapy.

What is 'painful arc syndrome'?

Pain experienced between 60 to 120 degrees of abduction due to subacromial impingement.

What are the three main types of femoral neck fractures?

Subcapital (intracapsular), intertrochanteric (extracapsular), and stress fractures.

Which type of femoral neck fracture has a high risk of avascular necrosis (AVN) and non-union, and why?

Subcapital (intracapsular) fractures due to compromise of blood supply.

What is the primary management for a non-displaced subcapital femoral neck fracture?

Internal fixation with cannulated screws.

How are displaced subcapital femoral neck fractures managed in elderly, low-demand patients?

Hemiarthroplasty (partial hip replacement).

What is the recommended treatment for displaced subcapital femoral neck fractures in active, high-demand patients?

Total Hip Arthroplasty (THA).

Why do intertrochanteric (extracapsular) femoral neck fractures have a lower risk of avascular necrosis (AVN) compared to subcapital fractures?

They are extracapsular, meaning the blood supply to the femoral head is less likely to be compromised.

What are the management options for stable intertrochanteric femoral neck fractures?

Dynamic Hip Screw (DHS) or intramedullary nail.

How are unstable or comminuted intertrochanteric femoral neck fractures typically managed?

With an intramedullary nail (e.g., proximal femoral nail).

What is the management strategy for low-risk (compression-sided) femoral neck stress fractures?

Conservative management with rest and non-weight bearing on crutches for 6 weeks.

Why do high-risk (tension-sided) femoral neck stress fractures require urgent internal fixation?

To prevent displacement, which can lead to more severe complications.