Questions and Answers
What is caused by a sudden, severe contraction of the quadriceps muscle while the knee is in a stretched valgus and external rotation position?
What percentage chance do patients have of experiencing recurrent patellar dislocation after non-operative treatment for a first-time dislocation?
Which of the following complications is most likely from a patellar dislocation?
What is the immediate treatment approach for a dislocated knee under anesthesia?
Signup and view all the answers
Which condition can predispose an individual to recurrent dislocation of the patella?
Signup and view all the answers
What type of fracture may result from a twisting force applied to the leg?
Signup and view all the answers
What is a key clinical feature to examine when assessing a dislocated knee?
Signup and view all the answers
What type of fracture is characterized by a separate triangular ‘butterfly’ fragment?
Signup and view all the answers
Which treatment is typically indicated for subtrochanteric fractures?
Signup and view all the answers
What is a common complication following femoral shaft fractures?
Signup and view all the answers
What defines a malunion in the context of femoral fractures?
Signup and view all the answers
In which scenario are intertrochanteric fractures likely to occur?
Signup and view all the answers
What is a characteristic feature of supracondylar fractures of the femur?
Signup and view all the answers
What complication is associated with the treatment of open femoral fractures?
Signup and view all the answers
Which of the following is a key characteristic of condylar fractures?
Signup and view all the answers
What is the most significant concern when treating femoral shaft fractures?
Signup and view all the answers
What is the most common mechanism of injury leading to a posterior dislocation of the hip?
Signup and view all the answers
Which position characterizes the lower limb in a posterior hip dislocation?
Signup and view all the answers
What complication occurs in 10-20% of cases after a posterior hip dislocation?
Signup and view all the answers
Which complication of traumatic hip dislocation has an increased risk if reduction is delayed beyond a few hours?
Signup and view all the answers
What is a common cause of fracture of the femoral neck in younger individuals?
Signup and view all the answers
During treatment, what is typically done after reduction of a posterior hip dislocation?
Signup and view all the answers
What are the initial steps in management of a hip dislocation?
Signup and view all the answers
Which of the following is NOT a factor contributing to the development of osteoarthritis after a hip dislocation?
Signup and view all the answers
What is the recommended treatment for markedly displaced and/or comminuted fractures of the lateral condyle?
Signup and view all the answers
Which method is typically employed for treating fractures of the medial condyle?
Signup and view all the answers
What can be a consequence of severe tibial plateau fractures?
Signup and view all the answers
What is a common mechanism that leads to tibial plateau fractures?
Signup and view all the answers
When treating undisplaced and minimally displaced fractures of the lateral condyle, what is the preferred approach?
Signup and view all the answers
What surgical technique might be required for bicondylar fractures due to their complexity?
Signup and view all the answers
What is a potential complication of tibial plateau fractures that can affect treatment outcomes?
Signup and view all the answers
What describes the term used for tibial plateau fractures resulting from a fall where the knee is forced into valgus or varus?
Signup and view all the answers
Which of the following is not a type of patellar fracture?
Signup and view all the answers
What is the main approach for treating an undisplaced patellar fracture?
Signup and view all the answers
In the management of a comminuted (stellate) fracture of the patella, which statement is true?
Signup and view all the answers
What mechanism is commonly associated with a displaced transverse fracture of the patella?
Signup and view all the answers
Which of the following complications should be closely monitored after a patellar fracture?
Signup and view all the answers
When treating a displaced transverse fracture, what is typically done to the extensor mechanism?
Signup and view all the answers
What daily activities are encouraged during the initial treatment of an undisplaced fracture?
Signup and view all the answers
Which of the following is a characteristic feature of a comminuted patellar fracture?
Signup and view all the answers
What type of patellar fracture is characterized by fragments resulting from high-energy trauma, often needing surgical intervention?
Signup and view all the answers
When managing an undisplaced patellar fracture, which treatment approach is typically recommended?
Signup and view all the answers
Which clinical feature is most commonly associated with patellar dislocation?
Signup and view all the answers
What is a common complication that may arise after a first-time patellar dislocation?
Signup and view all the answers
In the context of a patellar dislocation, which mechanism primarily causes the patella to dislocate laterally?
Signup and view all the answers
What type of management is crucial for a patient with a dislocated knee to identify possible circulatory issues?
Signup and view all the answers
In which scenario is a comminuted fracture likely to occur in relation to the patella?
Signup and view all the answers
What primary factor increases the risk of recurrent patellar dislocation?
Signup and view all the answers
Which type of patellar fracture is most likely to be caused by a direct blow?
Signup and view all the answers
What daily activity is emphasized during the treatment of an undisplaced patellar fracture?
Signup and view all the answers
In the management of a comminuted (stellate) patellar fracture, which procedure might be necessary if the undersurface is irregular?
Signup and view all the answers
What occurs when the extensor mechanism is disrupted in a displaced transverse fracture of the patella?
Signup and view all the answers
What type of fracture typically occurs in elderly patients due to trivial injuries?
Signup and view all the answers
What treatment is generally recommended for supracondylar fractures of the femur?
Signup and view all the answers
What key sign should be examined to monitor for complications following a patellar fracture?
Signup and view all the answers
In treating a comminuted fracture of the femur, what is a common complication to consider?
Signup and view all the answers
Which of the following best describes the mechanism leading to a transverse fracture of the patella?
Signup and view all the answers
What is a common complication that should be monitored after a patellar dislocation?
Signup and view all the answers
Which mechanism of injury is most commonly associated with femoral shaft fractures?
Signup and view all the answers
What complication is commonly linked to patellar dislocation?
Signup and view all the answers
Which type of patellar fracture would be least likely to allow the patient to lift their leg due to extensor mechanism involvement?
Signup and view all the answers
What is a characteristic feature indicating a condylar fracture?
Signup and view all the answers
What is one potential complication from a delayed reduction of a traumatic dislocation?
Signup and view all the answers
What defines a delayed union in the context of a fractured femur?
Signup and view all the answers
What is the treatment approach for undisplaced fractures of the lateral condyle?
Signup and view all the answers
Which type of fracture typically requires treatment with a buttress plate and screws?
Signup and view all the answers
What is the most likely complication associated with severe tibial plateau fractures?
Signup and view all the answers
Which statement accurately describes a common mechanism of injury leading to tibial plateau fractures?
Signup and view all the answers
What is typically required for managing a bicondylar fracture due to its complexity?
Signup and view all the answers
Which surgical treatment is recommended for markedly displaced fractures of the lateral condyle?
Signup and view all the answers
What is a potential consequence of untreated severe tibial plateau fractures?
Signup and view all the answers
What is commonly observed in patients with tibial plateau fractures associated with major vascular injury?
Signup and view all the answers
Which of the following best describes the mechanism of injury leading to a posterior dislocation of the hip?
Signup and view all the answers
What is a key characteristic of the position of the limb in a posterior hip dislocation?
Signup and view all the answers
After a posterior hip dislocation is successfully reduced, what is the typical next step in treatment?
Signup and view all the answers
What complication is most commonly associated with posterior hip dislocations involving sciatic nerve injury?
Signup and view all the answers
Which of the following factors increases the risk of avascular necrosis after a hip dislocation?
Signup and view all the answers
In evaluating the complications of dislocation of the hip, which of the following is NOT typically a consequence of cartilage injury?
Signup and view all the answers
What is the most appropriate treatment for a fracture of the femoral neck resulting from a fall onto the greater trochanter in a younger individual?
Signup and view all the answers
During the evaluation of a comminuted fracture of the femoral neck, which of the following characteristics would likely be assessed?
Signup and view all the answers
A comminuted patellar fracture is often caused by low-energy trauma and typically requires non-surgical management.
Signup and view all the answers
The management of an undisplaced patellar fracture generally favors prompt surgical repair to ensure proper healing.
Signup and view all the answers
A direct blow to the knee can cause an avulsion fracture of the patella due to the impact on the extensor mechanism.
Signup and view all the answers
Patellar dislocations predominantly occur medially due to the physiological alignment of the knee joint.
Signup and view all the answers
One potential complication of a patellar dislocation is the tearing of the medial patellofemoral ligament (MPFL).
Signup and view all the answers
Recurrent dislocation after a first episode is primarily influenced by lower proprioceptive awareness and muscle strength.
Signup and view all the answers
In patients treated for a first-time dislocation without surgery, the chance of experiencing another dislocation is approximately 30-40%.
Signup and view all the answers
The primary mechanism for patellar dislocation involves the quadriceps muscle contracting while the knee is in a straight position.
Signup and view all the answers
A comminuted or ‘stellate’ fracture of the patella is characterized by a direct blow to the knee.
Signup and view all the answers
Treatment for an undisplaced patellar fracture primarily involves maintaining knee flexibility while healing.
Signup and view all the answers
In a displaced transverse fracture of the patella, the entire extensor mechanism remains intact.
Signup and view all the answers
A transverse fracture with a gap between fragments indicates an indirect traction injury due to passive flexion of the knee during quadriceps contraction.
Signup and view all the answers
Compartment syndrome is a common complication that arises from improper treatment of patellar fractures.
Signup and view all the answers
A congenital bipartite patella can be easily confused with a fracture due to its smooth line extending across the bone.
Signup and view all the answers
Dislocated patellas can often lead to osteoarthritis if not addressed properly during initial treatment.
Signup and view all the answers
Quadriceps exercises are not necessary during the recovery of a displaced patellar fracture.
Signup and view all the answers
A comminuted patellar fracture is rarely associated with high-energy trauma and generally requires minimal intervention.
Signup and view all the answers
The treatment approach for an undisplaced patellar fracture usually involves surgery and immediate weight bearing.
Signup and view all the answers
Direct trauma is a common mechanism for patellar dislocation, often occurring when the knee is in a flexed position.
Signup and view all the answers
Joint stiffness, non-union, and vascular injury are common complications associated with patellar fractures.
Signup and view all the answers
Patellar fractures most frequently occur from indirect injuries rather than direct blows to the knee.
Signup and view all the answers
A common complication following non-surgical treatment for a patellar dislocation is recurrent patellar dislocation.
Signup and view all the answers
The management of a displaced transverse fracture typically emphasizes preserving the extensor mechanism.
Signup and view all the answers
A patellar fracture characterized by a high-energy mechanism often leads to a need for comprehensive rehabilitation post-surgery.
Signup and view all the answers
A patellar fracture can occur from a direct blow to the knee.
Signup and view all the answers
The recommended treatment for an undisplaced patellar fracture is immediate surgical intervention.
Signup and view all the answers
Comminuted fractures of the patella are often managed with non-weight bearing activities only.
Signup and view all the answers
A fall directly onto the knee can lead to a lateral patellar dislocation.
Signup and view all the answers
One common complication following a first-time patellar dislocation is the risk of recurrence.
Signup and view all the answers
Immediate treatment of a dislocated knee requires focusing on stabilizing the joint and checking for vascular status.
Signup and view all the answers
Osteoarthritis is more likely to develop in patients with retained fragments from a patellar fracture.
Signup and view all the answers
The mechanism of injury for a patellar fracture primarily involves pulling of the quadriceps muscle.
Signup and view all the answers
Comminuted patellar fractures are characterized by multiple bone fragments resulting from low-energy trauma.
Signup and view all the answers
Open reduction and internal fixation is rarely required for managing undisplaced fractures of the patellar region.
Signup and view all the answers
The primary mechanism causing a patellar dislocation involves the quadriceps muscle contracting excessively while the knee is in varus alignment.
Signup and view all the answers
All types of tibial plateau fractures require surgical intervention for effective treatment.
Signup and view all the answers
Risk of wound complications increases significantly when treating bicondylar fractures with external fixation alone.
Signup and view all the answers
Bumper fractures often occur as a result of car accidents where a pedestrian is struck on the knee.
Signup and view all the answers
In cases of patellar dislocation, monitoring for signs of compartment syndrome is not essential.
Signup and view all the answers
Management of comminuted patellar fractures often involves substantial fixation techniques to stabilize the injury.
Signup and view all the answers
Comminuted fractures of the tibial plafond can occur from severe axial compression, such as falling from a height.
Signup and view all the answers
All Salter–Harris fracture types involve a vertical split of the epiphysis.
Signup and view all the answers
Avascular necrosis is a common complication of fractures of the neck of the femur.
Signup and view all the answers
Fractures of the calcaneum commonly occur from falls onto one or both heels.
Signup and view all the answers
Fractures of the head of the talus are among the most common injuries following a car accident.
Signup and view all the answers
Extra-articular fractures of the calcaneum specifically affect the bony processes or the anterior part of the bone.
Signup and view all the answers
Severe comminution in ankle fractures may extend up the shaft of the tibia.
Signup and view all the answers
The degree of fracture displacement does not influence the risk of avascular necrosis in talar fractures.
Signup and view all the answers
Patients with calcaneum fractures often suffer from associated injuries to the spine, pelvis, or hip.
Signup and view all the answers
Fractures in the talus are considered common due to their low mobility.
Signup and view all the answers
Intra-articular fractures cleave the bone accurately and run into the inferior articular surface.
Signup and view all the answers
Broadening of the heel is a common complication that can lead to issues with shoe fitting.
Signup and view all the answers
Talocalcaneal stiffness is an immediate consequence of minor midtarsal injuries.
Signup and view all the answers
Medial midtarsal dislocation appears similar to an 'acute clubfoot.'
Signup and view all the answers
Fractures isolated to the navicular, cuneiform, or cuboid bones are commonly seen.
Signup and view all the answers
The Lisfranc fracture-dislocation is associated with sprains of the foot.
Signup and view all the answers
Stress fractures primarily occur in athletes and can manifest as a tender lump distal to the mid-shaft of the second metatarsal.
Signup and view all the answers
Dislocations of the tarsometatarsal region are frequently associated with twisting and crushing injuries.
Signup and view all the answers
Acute clubfoot is a condition generally linked to lateral midtarsal dislocations.
Signup and view all the answers
Joint stiffness and osteoarthritis are not typical complications of severe intra-articular fractures.
Signup and view all the answers
What is the primary complication associated with fractures of the neck of the talus?
Signup and view all the answers
Which type of Salter-Harris fracture indicates that the epiphysis is split vertically and may become displaced?
Signup and view all the answers
What is a common mechanism of injury for talar fractures?
Signup and view all the answers
In the context of calcaneum fractures, what is the primary cause of injury?
Signup and view all the answers
Which fracture type involves shattering of the tibial plafond due to severe axial compression?
Signup and view all the answers
What is a possible consequence of untreated Type 3 or Type 4 Salter-Harris fractures?
Signup and view all the answers
What percentage of patients with calcaneum fractures also suffer from associated injuries?
Signup and view all the answers
What kind of fractures can result from fractures of the talus?
Signup and view all the answers
After a fall from a height, which injury to the ankle is most often observed?
Signup and view all the answers
What type of fracture is characterized by splitting or crushing of the calcaneum?
Signup and view all the answers
What complication is commonly associated with intra-articular fractures?
Signup and view all the answers
Which type of midtarsal dislocation produces a valgus deformity?
Signup and view all the answers
What is a common mechanism leading to metatarsal fractures?
Signup and view all the answers
What is the most typical presentation of a stress (march) fracture in the foot?
Signup and view all the answers
Which of the following best describes extra-articular fractures?
Signup and view all the answers
Which injury is characterized by combination fractures or fracture-dislocations in the midtarsal area?
Signup and view all the answers
In cases of tarsometatarsal injuries, what is the usual cause of dislocation?
Signup and view all the answers
What common issue can result from a broadening of the heel following an intra-articular fracture?
Signup and view all the answers
How should fractures in the midtarsal region be approached in terms of injury classification?
Signup and view all the answers
What is a potential consequence of isolated injuries of the navicular, cuneiform, or cuboid bones?
Signup and view all the answers
What complication commonly arises from broadening of the heel due to intra-articular fractures?
Signup and view all the answers
What is a potential outcome of displaced intra-articular fractures?
Signup and view all the answers
What appearance does a medial midtarsal dislocation resemble?
Signup and view all the answers
In midtarsal injuries, which type of injury is rare compared to others?
Signup and view all the answers
What type of fracture can commonly be expected from a twisting force applied to the leg?
Signup and view all the answers
What should be suspected if a patient experiences pain, swelling, and bruising of the foot after an accident?
Signup and view all the answers
Which injury is characterized by the presence of a tender lump distal to the mid-shaft of a metatarsal bone?
Signup and view all the answers
What type of injuries are typical causes of tarsometatarsal injuries?
Signup and view all the answers
What complication is commonly associated with severe fracture-dislocations in the foot?
Signup and view all the answers
What is a common cause of metatarsal fractures?
Signup and view all the answers
What is a potential outcome if a Type 3 or Type 4 Salter-Harris fracture is not accurately reduced?
Signup and view all the answers
What is a common cause of talar injuries?
Signup and view all the answers
Which of the following fragments is at risk of avascular necrosis (AVN) due to neck fractures of the talus?
Signup and view all the answers
When a patient falls from a height onto one or both heels, which type of fracture is commonly sustained?
Signup and view all the answers
What type of injury does a comminuted fracture of the tibial plafond typically involve?
Signup and view all the answers
What is a significant risk associated with fractures of the neck of the talus?
Signup and view all the answers
Which of the following is true regarding extra-articular fractures of the calcaneum?
Signup and view all the answers
In which scenario is a calcaneal fracture most likely to occur?
Signup and view all the answers
Which statement is correct regarding the Salter-Harris classification of fractures?
Signup and view all the answers
Which type of fracture is most likely to happen in patients with severe axial trauma?
Signup and view all the answers
What type of fracture is caused by severe axial compression of the ankle joint?
Signup and view all the answers
In the Salter-Harris classification, what does a Type 3 fracture indicate?
Signup and view all the answers
What is a common complication following a fracture of the neck of the talus?
Signup and view all the answers
What mechanism commonly causes fractures of the calcaneum?
Signup and view all the answers
What type of injury may occur due to considerable violence and is characterized by the fracture of multiple areas of the talus?
Signup and view all the answers
What can happen if Type 4 fractures in the Salter-Harris classification are not accurately reduced?
Signup and view all the answers
Which of the following correctly describes a common consequence of fractures to the calcaneum?
Signup and view all the answers
What term describes the fragmentation of bone often seen in severe ankle injuries?
Signup and view all the answers
What is a significant risk factor for avascular necrosis following talar neck fractures?
Signup and view all the answers
Which type of talar injury involves fractures of the bony processes or dislocations of the talus?
Signup and view all the answers
What is a common complication that may arise due to intra-articular fractures?
Signup and view all the answers
What can be a significant consequence of a medial midtarsal dislocation?
Signup and view all the answers
Which injuries are common in the midtarsal region?
Signup and view all the answers
Which factor is commonly associated with stress fractures in the foot?
Signup and view all the answers
What is a notable feature of the broadening of the heel due to complications from fractures?
Signup and view all the answers
What is a usual cause of tarsometatarsal injuries?
Signup and view all the answers
An isolated injury to which bone is considered rare?
Signup and view all the answers
What visual indication might suggest a lateral midtarsal dislocation?
Signup and view all the answers
What condition may result from chronic overuse, particularly in young adults active in sports?
Signup and view all the answers
Which type of fracture often requires surgery due to complications like dislocation?
Signup and view all the answers
What type of fracture is best treated with locked intramedullary nailing?
Signup and view all the answers
What is a common management strategy for stable fractures?
Signup and view all the answers
Which of the following is considered a late sign of compartment syndrome?
Signup and view all the answers
What is a primary objective in managing compartment syndrome?
Signup and view all the answers
What condition is commonly associated with a feeling of tightness or 'bursting' in the leg?
Signup and view all the answers
Which of the following best describes malunion in long bone fractures?
Signup and view all the answers
Which treatment method is typically indicated for unstable fractures at the outset?
Signup and view all the answers
What is a critical factor in the management of lower limb injuries to reduce soft tissue damage?
Signup and view all the answers
What is the recommended treatment for subtrochanteric fractures?
Signup and view all the answers
What is a common complication associated with femoral shaft fractures?
Signup and view all the answers
What characterizes intertrochanteric fractures?
Signup and view all the answers
Which complication is a concern following open injuries of the femur?
Signup and view all the answers
What is a primary mechanism for supracondylar fractures of the femur?
Signup and view all the answers
What deformity may occur with malunion of a femoral fracture?
Signup and view all the answers
What is a critical consideration in the management of femoral shaft fractures?
Signup and view all the answers
What type of fracture is characterized by a gap between the fragments due to forced flexion of the knee?
Signup and view all the answers
Which type of fracture involves a pull by the gastrocnemius muscle?
Signup and view all the answers
Which treatment approach is recommended for managing a comminuted patellar fracture?
Signup and view all the answers
What is a common outcome of knee dislocation not addressed promptly?
Signup and view all the answers
What complication should be closely monitored after a patellar fracture?
Signup and view all the answers
What should be palpated in a patient with a supracondylar fracture of the femur?
Signup and view all the answers
What is often the mechanism of injury associated with a patellar fracture?
Signup and view all the answers
Which complication is specifically linked to compartment syndrome in the lower limb?
Signup and view all the answers
What is the typical cause of a fracture of the femoral neck in younger individuals?
Signup and view all the answers
What complication occurs in approximately 10-20% of cases following a posterior hip dislocation?
Signup and view all the answers
Which step is typically taken immediately after the reduction of a posterior hip dislocation?
Signup and view all the answers
What increases the risk of avascular necrosis following a traumatic hip dislocation?
Signup and view all the answers
What typically characterizes the position of the lower limb in a posterior dislocation of the hip?
Signup and view all the answers
What factor contributes to the development of osteoarthritis after a hip dislocation?
Signup and view all the answers
What is a common mechanism for a central dislocation of the hip?
Signup and view all the answers
What should be protected to prevent injury during recovery from a sciatic nerve injury?
Signup and view all the answers
What is an essential management step for a dislocated knee?
Signup and view all the answers
What is a common consequence of failure to promptly treat a traumatic hip dislocation?
Signup and view all the answers
What mechanism primarily leads to a spiral fracture of both the tibia and fibula?
Signup and view all the answers
What is a vital clinical feature to observe when assessing a dislocated knee?
Signup and view all the answers
Which of the following best describes a short oblique fracture?
Signup and view all the answers
What is typically included in the urgent treatment for a dislocated knee?
Signup and view all the answers
What complication arises from non-operative treatment of a first-time patellar dislocation?
Signup and view all the answers
Which factor does NOT predispose to recurrent dislocation of the patella?
Signup and view all the answers
Which injury mechanism is most likely to cause a dislocated knee?
Signup and view all the answers
What is commonly revealed in X-rays when assessing a dislocated knee?
Signup and view all the answers
What should be checked repetitively in the treatment of a dislocated knee?
Signup and view all the answers
Which of the following statements is true regarding the management of knee dislocations?
Signup and view all the answers
A full-length cast is applied for stable fractures that are undisplaced or minimally displaced.
Signup and view all the answers
Plate fixation is preferred for treating diaphyseal fractures.
Signup and view all the answers
Compartment syndrome is characterized by the absence of pulses as a late sign.
Signup and view all the answers
Skeletal fixation treatment is not recommended for low-energy unstable fractures.
Signup and view all the answers
Tenting of the skin and diminished sensation can indicate a closed fracture.
Signup and view all the answers
Numbness and increasing pain are early warning symptoms of compartment syndrome.
Signup and view all the answers
Early weightbearing is encouraged in fracture management to promote healing.
Signup and view all the answers
A valgus deformity is more easily compensated for by the normal ankle than a varus deformity.
Signup and view all the answers
Intertrochanteric fractures are most commonly associated with trivial injuries in elderly patients.
Signup and view all the answers
Subtrochanteric fractures are characterized by their occurrence only in young adults.
Signup and view all the answers
The treatment of choice for femoral shaft fractures is usually open reduction and internal fixation.
Signup and view all the answers
Complications from Achilles tendon injuries include joint stiffness and non-union.
Signup and view all the answers
Vascular injury is a common complication associated with femoral shaft fractures.
Signup and view all the answers
An undisplaced fracture of the patella results from direct trauma.
Signup and view all the answers
Malunion in the context of femoral fractures is defined as having no more than 20 degrees of angulation.
Signup and view all the answers
In supracondylar fractures of the femur, direct trauma is the typical cause.
Signup and view all the answers
Comminuted fractures of the patella involve the extensor mechanism being torn completely.
Signup and view all the answers
The management of a displaced transverse fracture involves repairing the extensor mechanism.
Signup and view all the answers
One or both femoral condyles may be fractured in condylar fractures.
Signup and view all the answers
Injuries that result in knee dislocations are always a result of high-energy impacts.
Signup and view all the answers
Joint stiffness is a complication associated with patellar dislocations.
Signup and view all the answers
A transverse fracture of the patella is classified as a direct trauma injury.
Signup and view all the answers
Locking intramedullary nails can be used for treating supracondylar fractures of the femur.
Signup and view all the answers
A posterior dislocation of the hip commonly occurs when the leg is short and lies adducted.
Signup and view all the answers
Avascular necrosis occurs in 20% of traumatic hip dislocations if reduction is delayed for several hours.
Signup and view all the answers
The sciatic nerve is typically damaged in 30-40% of cases of hip dislocation.
Signup and view all the answers
In the management of hip dislocation, movement and exercises should begin immediately after the injury.
Signup and view all the answers
A fracture of the femoral neck in younger individuals is often due to a fall from a height.
Signup and view all the answers
Complications such as osteoarthritis can occur due to cartilage damage at the time of hip dislocation.
Signup and view all the answers
A central dislocation of the hip is typically treated with immediate surgical intervention only.
Signup and view all the answers
The presence of retained fragments in the joint is a contributing factor to the development of osteoarthritis post-dislocation.
Signup and view all the answers
Traction is maintained for up to two weeks following a hip dislocation reduction.
Signup and view all the answers
The lower limb is examined for signs of injury to the femoral nerve following a hip dislocation.
Signup and view all the answers
A twisting force can cause a spiral fracture of the tibia and fibula.
Signup and view all the answers
Recurrent dislocation of the patella has a 10-15% chance after non-operative treatment.
Signup and view all the answers
The medial patellofemoral ligament is often torn in a lateral dislocation of the patella.
Signup and view all the answers
A dislocated knee typically occurs without significant violence.
Signup and view all the answers
A back-slab with the knee in 30 degrees of flexion is used for urgent reduction of a dislocated knee.
Signup and view all the answers
The popliteal artery must be examined to ensure it is not torn or obstructed in the setting of a knee dislocation.
Signup and view all the answers
Short oblique fractures can result from an angulatory force on the leg.
Signup and view all the answers
After a knee dislocation, distal sensation and movement should be tested for potential nerve injury.
Signup and view all the answers
Marked genu varum is a predisposing factor for recurrent patellar dislocation.
Signup and view all the answers
Clinical features of knee dislocation include severe bruising and gross deformity.
Signup and view all the answers
Intra-articular fractures cleave the bone vertically and run into the inferior articular surface.
Signup and view all the answers
Broadening of the heel can cause issues with shoe fitting.
Signup and view all the answers
Isolated injuries of the navicular, cuneiform, or cuboid bones are very common.
Signup and view all the answers
A medial midtarsal dislocation produces a varus deformity.
Signup and view all the answers
Metatarsal fractures can be caused by severe twisting injuries.
Signup and view all the answers
A tender lump distal to the mid-shaft of a metatarsal bone is common in stress fractures.
Signup and view all the answers
Talocalcaneal stiffness can lead to osteoarthritis following displaced intra-articular fractures.
Signup and view all the answers
Twisting and crushing injuries are rare causes of tarsometatarsal injuries.
Signup and view all the answers
Compartment syndrome should always be excluded in suspected midtarsal dislocations.
Signup and view all the answers
Mid-tarsal injuries may vary from minor sprains to severe fracture–dislocations.
Signup and view all the answers
Severe axial compression of the ankle joint can shatter the tibial plafond.
Signup and view all the answers
Fractures of the talus are common injuries.
Signup and view all the answers
Comminuted fractures of the tibial plafond often lead to damage of the articular cartilage.
Signup and view all the answers
Avascular necrosis is unlikely to occur in fractures of the neck of the talus.
Signup and view all the answers
Type 1 Salter–Harris fractures involve the epiphysis being split vertically.
Signup and view all the answers
Fractures of the calcaneum can occur from falls from heights.
Signup and view all the answers
Comminuted tibial plafond fractures can extend up the shaft of the bone.
Signup and view all the answers
The calcaneus is always uninjured in falls from height.
Signup and view all the answers
Failure to accurately reduce Type 3 or 4 Salter-Harris fractures can lead to abnormal growth.
Signup and view all the answers
What is a common complication of intra-articular fractures?
Signup and view all the answers
Which injury is characterized by significant pain, swelling, and bruising of the foot after an accident?
Signup and view all the answers
What is the characteristic appearance of a medial midtarsal dislocation?
Signup and view all the answers
What can lead to broadening of the heel as a complication?
Signup and view all the answers
Which type of injury in the midtarsal area poses a threat to the survival of the foot?
Signup and view all the answers
What type of fracture is primarily caused by direct blows or severe twisting injuries?
Signup and view all the answers
What is a common location for a stress fracture in a young adult engaged in strenuous activity?
Signup and view all the answers
Which type of dislocation results in a valgus deformity?
Signup and view all the answers
What is the presumed nature of fractures in the midtarsal area?
Signup and view all the answers
What is a potential complication that may arise after intra-articular fractures?
Signup and view all the answers
What is a significant consequence of a comminuted fracture of the tibial plafond?
Signup and view all the answers
What characterizes a Type 3 Salter-Harris fracture?
Signup and view all the answers
What increase the risk of avascular necrosis (AVN) in talar fractures?
Signup and view all the answers
Which type of injury commonly occurs due to falls from height impacting the heel?
Signup and view all the answers
What commonly accompanies calcaneal fractures in over 20% of cases?
Signup and view all the answers
What is a notable characteristic of talar injuries?
Signup and view all the answers
What happens if a Type 4 Salter-Harris fracture is not accurately reduced?
Signup and view all the answers
What type of fractures are classified as extra-articular fractures of the calcaneum?
Signup and view all the answers
Which type of fracture is most at risk of failing to unite in talar neck fractures?
Signup and view all the answers
What is often seen in patients with significant ankle injuries such as those involving the tibial plafond?
Signup and view all the answers
Study Notes
Dislocation of the Patella
- The knee's natural valgus angle encourages lateral pull on the patella during quadriceps contraction.
- Traumatic dislocation often results from sudden quadriceps contraction while the knee is externally rotated and in valgus, commonly occurring in field sports.
- Lateral dislocation may tear medial retinacular fibers and the medial patellofemoral ligament (MPFL).
- Non-operative treatment for first-time dislocation carries a 15-20% chance of recurrent dislocations.
- Risk factors for recurrence include generalized joint laxity, genu valgum, and high patella.
Dislocation of the Knee
- Knee dislocation requires significant trauma, like in a road accident.
- Cruciate ligaments are typically torn, and there may be collateral ligament injuries.
- Clinical signs include severe bruising, swelling, and visible deformity.
- Popliteal artery injury must be ruled out through circulation checks, and nerve function should be assessed.
- X-rays may reveal tibial spine fractures due to ligament avulsion; arteriography may be necessary if circulation is in doubt.
- Urgent reduction under anesthesia is required, often supported by a back-slab in 15 degrees of flexion.
Fractures of the Tibia and Fibula
- Spiral fractures stem from twisting forces, while angular forces lead to oblique fractures with potential butterfly fragments.
- Common clinical symptoms include bruising, severe swelling, and limb shortening with external rotation.
Intertrochanteric Fractures
- Typically caused by direct trauma, these fractures occur in the proximal femur.
- Complications include fixation failure, where screws may cut out of osteoporotic bone, and potential malunion with varus or external rotation deformities.
Subtrochanteric Fractures
- Often present in the elderly, these fractures go through or below the lesser trochanter and are frequently comminuted.
- Open reduction and internal fixation are the standard treatment approaches.
Femoral Shaft Fractures
- Common in young adults and usually result from high-energy injuries.
- High muscle padding can protect but may cause severe displacement, complicating reduction.
- Complications include vascular injuries, thromboembolism, infections, delayed or non-union, and joint stiffness.
Supracondylar Fractures of the Femur
- Direct trauma above the femoral condyles may result in these fractures.
- Gastrocnemius muscle pull may cause the distal fragment to tilt backward.
- Tibial pulses should be palpated to assess vascular integrity.
Condylar Fractures
- Fractures can occur in one or both femoral condyles, often characterized by knee swelling and a feel of hemorrhagic effusion.
Tibial Plateau Fractures
- Result from bending forces and axial loads, often termed "bumper fractures" due to vehicle impacts.
- Fractures can crush or split the tibial condyles, and associated ligament injuries may occur.
Treatment of Tibial Plateau Fractures
- Undisplaced fractures may be treated conservatively, while marked displacement often requires open reduction and internal fixation.
- Medial condyle fractures are complex and best managed using buttress plates and screws.
- Bicondylar fractures require internal fixation and care for potential compartment syndrome.
Fracture of the Patella
- Three main types of patellar fractures:
- Undisplaced fractures from direct blows.
- Comminuted (stellate) fractures.
- Transverse fractures due to forced knee flexion with a contracted quadriceps.
- Treatment varies by fracture type, focusing on the integrity of the extensor mechanism.
- Undisplaced fractures receive protective treatment; comminuted forms may require partial patellectomy; displaced transverse fractures need internal fixation and extensor expansion repair.### Complications of Fractures
- Compartment syndrome requires repeated examination of the leg and foot for signs.
- Possible complications include joint stiffness, deformity, and osteoarthritis.
Fracture of the Patella
- Types of fractures include:
- Undisplaced fracture from a direct blow.
- Comminuted or ‘stellate’ fracture.
- Transverse fracture due to forced passive flexion of the knee; extensor mechanism disrupted.
- Importance of distinguishing patellar fractures from congenital bipartite patella.
Treatment of Patellar Fractures
- Undisplaced fractures require protective treatment and knee immobilization for 4-6 weeks, with daily quadriceps exercises.
- Comminuted fractures pose a risk to the patellofemoral joint; may require partial patellectomy.
- Displaced transverse fractures necessitate internal fixation and repair of the extensor mechanism; braces used until knee extension is regained.
Intertrochanteric and Subtrochanteric Fractures
- Intertrochanteric fractures can lead to fixation failure and malunion with varus or external rotation deformities.
- Subtrochanteric fractures often occur in the elderly from trivial injuries; treatment is usually open reduction and internal fixation.
Femoral Shaft Fractures
- Common in young adults, usually from high-energy impacts; muscle pull can cause severe displacement complicating reduction.
- Potential complications include vascular injury, thromboembolism, infection, delayed union, non-union, and joint stiffness.
Supracondylar and Condylar Femur Fractures
- Supracondylar fractures result from direct trauma; treatment includes skeletal traction or open reduction with internal fixation.
- Condylar fractures may present with knee swelling due to hemarthrosis and require careful assessment for treatment.
Dislocation of the Hip
- Posterior dislocation is common after road accidents; presents with a short, adducted, internally rotated limb.
- Complications include sciatic nerve injury (10-20% occurrence) and avascular necrosis, especially if reduction is delayed.
Fracture of the Femoral Neck
- Typically results from falls on the greater trochanter; younger individuals may suffer from high-impact trauma.
- Open reduction and internal fixation are the standard treatment.
Tibial Plateau Fractures
- Often result from bending forces and axial loads, commonly seen in accidents involving pedestrians or in falls.
- Treatment varies; undisplaced fractures may be managed conservatively, while displaced fractures require surgical intervention.
Comminuted Fractures of the Tibial Plafond (Pilon Fractures)
- Caused by severe axial compression, notably from falls; these fractures result in extensive damage to articular cartilage.
- Treatment focuses on stabilization and addressing associated complications.
Ankle Fractures in Children
- Utilize Salter-Harris classification; Type 3 and 4 fractures involve vertically split epiphyses, risking poor growth if not reduced accurately.
Fracture of the Talus
- Rare but serious injuries resulting from significant trauma; include fractures of various parts of the talus.
- Avascular necrosis is a major concern with neck of the talus fractures.
Fractures of the Calcaneum
- Often occur from falls, causing split or crush injuries; can be associated with other significant injuries.
- Common complications include broadening of the heel, leading to fitting issues and potential osteoarthritis.
MID-TARSAL Injuries
- Range from minor sprains to severe fractures that may threaten foot viability; isolated navicular or cuneiform fractures are rare.
- Mid-tarsal dislocations may present as acute clubfoot or valgus deformity, requiring assessment for ischemia or compartment syndrome.
Tarsometatarsal and Metatarsal Fractures
- Fractures may result from direct blows, twisting injuries, or repetitive stress.
- Stress fractures commonly occur in active individuals, presenting as localized pain and tenderness along the mid-shaft of a metatarsal.### Comminuted Fractures of the Tibial Plafond (Pilon Fractures)
- Occurs due to severe axial compression, such as falls from a height.
- Results in shattering of the tibial plafond, causing significant articular cartilage and subchondral bone damage.
- Severe cases may involve fracture extension up the shaft of the tibia.
Ankle Fractures in Children
- Classified using Salter-Harris system (Types 1 to 4).
- Types 3 and 4 involve vertical splitting of the epiphysis, which, if unreduced, leads to abnormal growth and deformity.
Fracture of the Talus
- Rare injuries typically from high-force events like car accidents or falls.
- Types include fractures of the head, neck, body, bony processes, dislocations, and osteochondral fractures.
- Complications include avascular necrosis (AVN) of the talus, especially from neck fractures, depending on displacement severity.
Fractures of the Calcaneum
- Often arise from falls from heights, leading to compression against the talus.
- Commonly associated with injuries to the spine, pelvis, or hip.
- Differentiate between extra-articular (involving calcaneal processes) and intra-articular fractures (cleaving into the superior articular surface).
Complications of Calcaneal Fractures
- Broadening of the heel can cause shoe-fitting issues and affect peroneal tendons/sural nerve.
- Intra-articular fractures can lead to talocalcaneal stiffness and osteoarthritis.
Midtarsal Injuries
- Present from minor sprains to severe fracture-dislocations threatening foot viability.
- Isolated fractures of navicular, cuneiform, or cuboid bones are rare; combination fractures are more common.
Tarsometatarsal Injuries
- Commonly result from twisting/crushing injuries, with sprains being frequent but dislocations rare.
- Suspect fracture-dislocation in patients with post-accident foot pain, swelling, and bruising, even without obvious deformity.
Lisfranc Fracture Dislocation
- Result from direct trauma or stress mechanisms impacting the tarsometatarsal region.
Metatarsal Stress (March) Fractures
- Common in physically active individuals, particularly new recruits or athletes experiencing overuse.
- Symptoms include localized tenderness and possible skin tenting or open wounds.
Management Objectives for Fractures
- Limit soft tissue damage and maintain skin integrity.
- Achieve and maintain fracture alignment.
- Monitor for compartment syndrome with early recognition.
- Initiate early weight-bearing and joint movement.
Treatment Approaches
- Stable fractures: Full-length casts are applied; knee slightly flexed, and ankle at right angle.
- Unstable fractures: Utilize skeletal fixation; locked intramedullary nailing preferred for diaphyseal fractures; plate fixation for metaphyseal fractures.
Open and High-Grade Injury Complications
- Includes vascular injuries, compartment syndrome (characterized by tightness, pain, and late numbness), and infections.
- Timely identification and fasciotomy for compartment syndrome critical.
Dislocations of the Patella
- Often occur due to intense quadriceps contraction with valgus knee position.
- Typically dislocate laterally, risking medial retinacular and MPFL injuries.
- Recurrent dislocation risk in conservatively treated patients.
Knee Dislocation
- Often results from severe trauma (e.g., road accidents), necessitating examination for vascular and nerve injuries.
- Requires urgent reduction under anesthesia; stability maintained via external fixators if necessary.
Tibia and Fibula Fractures
- Caused by twisting or angulatory forces; common complications include compartment syndrome and joint stiffness.
Patella Fractures
- Types include undisplaced, comminuted, and displaced transverse fractures.
- Treatment varies with fracture type; stabilization of extensor mechanism is crucial for recovery.
Intertrochanteric and Subtrochanteric Fractures
- Common in elderly due to trivial injuries; often require open reduction and fixation.
- Generally associated with complications such as malunion and fixation failure.
Femoral Shaft Fractures
- Common in young adults due to high-energy trauma; complicated by significant muscle pull leading to displacement.
- Watch for joint stiffness, malunion, and infection.
Femoral Neck Fractures
- Often due to falls; have risks of compartment syndrome and long-term joint issues like osteoarthritis.
Hip Dislocations
- Posterior dislocations from road accidents; leg typically short, adducted, and internally rotated.
- Immediate reduction is crucial to prevent complications like sciatic nerve injury and avascular necrosis.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers the crucial aspects of patella dislocation and knee dislocation. It addresses causes, risk factors, and clinical features associated with these injuries, particularly in sports contexts. Understanding these concepts is vital for anyone studying sports medicine or orthopedics.