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Questions and Answers
What is the treatment for a displaced distal clavicle fracture with a wish to avoid a second procedure?
What is the treatment for a displaced distal clavicle fracture with a wish to avoid a second procedure?
- Both A and B (correct)
- Coracoclavicular ligament reconstruction
- Small fragment plate fixation
- Hemiarthroplasty
What describes the Neer classification?
What describes the Neer classification?
It describes lateral third distal clavicle fracture.
Which nerve root is at risk of injury with retractor placement on the anterior aspect of the sacrum?
Which nerve root is at risk of injury with retractor placement on the anterior aspect of the sacrum?
L5 nerve root.
What is the greatest stress factor on lesser tuberosity fixation after hemiarthroplasty?
What is the greatest stress factor on lesser tuberosity fixation after hemiarthroplasty?
What is the greatest oxygen requirement per meter walked following prosthesis fitting?
What is the greatest oxygen requirement per meter walked following prosthesis fitting?
What is the treatment for a trans-olecranon fracture dislocation?
What is the treatment for a trans-olecranon fracture dislocation?
What does APC Type III indicate?
What does APC Type III indicate?
What is the restoration focus for both bone fractures?
What is the restoration focus for both bone fractures?
What is the next step in treatment for hypertrophic diaphyseal tibial nonunion?
What is the next step in treatment for hypertrophic diaphyseal tibial nonunion?
What is the definition of the talocrural angle of an ankle mortise x-ray?
What is the definition of the talocrural angle of an ankle mortise x-ray?
What does an anteromedial marginal impaction of the ankle indicate?
What does an anteromedial marginal impaction of the ankle indicate?
What is the surgical treatment for a Sanders IV intra-articular calcaneus fracture with a mechanical block to dorsiflexion?
What is the surgical treatment for a Sanders IV intra-articular calcaneus fracture with a mechanical block to dorsiflexion?
What is referred to as a Hoffa fracture?
What is referred to as a Hoffa fracture?
Which radiographic view best ensures screw placement does not exit the posterior aspect of the superior pubic ramus?
Which radiographic view best ensures screw placement does not exit the posterior aspect of the superior pubic ramus?
What is necessary to ensure screw placement outside of the joint?
What is necessary to ensure screw placement outside of the joint?
Gender is a risk factor for elder abuse.
Gender is a risk factor for elder abuse.
What types of ligaments does the IOM that bridges the radius and ulna include?
What types of ligaments does the IOM that bridges the radius and ulna include?
What is the treatment for a comminuted proximal humerus fracture?
What is the treatment for a comminuted proximal humerus fracture?
How is the height of the shoulder hemi prosthesis best determined?
How is the height of the shoulder hemi prosthesis best determined?
Formal physical therapy following distal radius fracture ORIF provides more benefits compared to patient-guided home exercise programs.
Formal physical therapy following distal radius fracture ORIF provides more benefits compared to patient-guided home exercise programs.
What is the treatment for a displaced femoral neck fracture?
What is the treatment for a displaced femoral neck fracture?
What are the advantages of bipolar hemiarthroplasty compared to total hip arthroplasty?
What are the advantages of bipolar hemiarthroplasty compared to total hip arthroplasty?
What defines a both columns acetabular fracture?
What defines a both columns acetabular fracture?
What is a Syme amputation?
What is a Syme amputation?
What is a contraindication for Syme amputation?
What is a contraindication for Syme amputation?
What soft tissue attachment is maintained by the Chaput fragment in pilon fractures?
What soft tissue attachment is maintained by the Chaput fragment in pilon fractures?
What soft tissue attachment is maintained by the Volkmann fragment in pilon fractures?
What soft tissue attachment is maintained by the Volkmann fragment in pilon fractures?
What are the types of nonunion?
What are the types of nonunion?
What would happen if an iliosacral screw penetrates through the sacral ala?
What would happen if an iliosacral screw penetrates through the sacral ala?
What is the risk associated with humeral hemiarthroplasty when the humeral head is below the top of the greater tuberosity?
What is the risk associated with humeral hemiarthroplasty when the humeral head is below the top of the greater tuberosity?
What has been associated with a lower incidence of complex regional pain syndrome (CRPS) in patients with distal radius fractures?
What has been associated with a lower incidence of complex regional pain syndrome (CRPS) in patients with distal radius fractures?
What is the recommended treatment for shortened clavicle fractures greater than 2 cm?
What is the recommended treatment for shortened clavicle fractures greater than 2 cm?
What is the treatment for olecranon fractures with significant comminution?
What is the treatment for olecranon fractures with significant comminution?
What is the rate of anterior knee pain complication after intramedullary nailing of the tibia?
What is the rate of anterior knee pain complication after intramedullary nailing of the tibia?
What is the expected outcome of ORIF for a highly comminuted radial head fracture?
What is the expected outcome of ORIF for a highly comminuted radial head fracture?
What is the delayed treatment for a highly comminuted radial head fracture?
What is the delayed treatment for a highly comminuted radial head fracture?
What is observed with the radiocapitellar joint during closed reduction of Monteggia fractures?
What is observed with the radiocapitellar joint during closed reduction of Monteggia fractures?
What indicates residual end-organ hypoperfusion in a polytraumatized patient?
What indicates residual end-organ hypoperfusion in a polytraumatized patient?
Which Risser sign has the greatest velocity of skeletal linear growth?
Which Risser sign has the greatest velocity of skeletal linear growth?
What do the Risser grades (0-V) measure?
What do the Risser grades (0-V) measure?
What malalignments are common in proximal tibial shaft fractures treated with intramedullary nails?
What malalignments are common in proximal tibial shaft fractures treated with intramedullary nails?
What can be employed to avoid apex anterior and valgus deformities with IM nail for proximal tibial shaft fractures?
What can be employed to avoid apex anterior and valgus deformities with IM nail for proximal tibial shaft fractures?
What does the ilioinguinal approach provide access to?
What does the ilioinguinal approach provide access to?
What nerve is at risk with the ilioinguinal approach?
What nerve is at risk with the ilioinguinal approach?
What is the Kocher-Langenbeck approach used for?
What is the Kocher-Langenbeck approach used for?
What does the Watson-Jones approach provide anterolateral access for?
What does the Watson-Jones approach provide anterolateral access for?
What visualization does the extended iliofemoral approach provide?
What visualization does the extended iliofemoral approach provide?
What is the Hardinge approach?
What is the Hardinge approach?
What percentage of normal circulating blood is needed for tachycardia with narrowed BP to present?
What percentage of normal circulating blood is needed for tachycardia with narrowed BP to present?
What is the most common complication noted in proximal humerus ORIF?
What is the most common complication noted in proximal humerus ORIF?
What is the rate of avascular necrosis (AVN) in valgus impacted 4-part proximal humerus fractures?
What is the rate of avascular necrosis (AVN) in valgus impacted 4-part proximal humerus fractures?
What are the absolute surgical indications for a humeral shaft fracture?
What are the absolute surgical indications for a humeral shaft fracture?
What is the gold standard treatment for a humeral shaft fracture?
What is the gold standard treatment for a humeral shaft fracture?
What is the treatment for a humeral shaft fracture malunion?
What is the treatment for a humeral shaft fracture malunion?
What is a Holstein-Lewis fracture?
What is a Holstein-Lewis fracture?
What defines a non-operative ulna fracture?
What defines a non-operative ulna fracture?
Flashcards
Clavicle fracture treatment
Clavicle fracture treatment
Displaced distal clavicle fractures may need plate fixation and coracoclavicular ligament repair to prevent future problems.
Neer classification
Neer classification
A way to categorize lateral third distal clavicle fractures.
Long clavicle fracture
Long clavicle fracture
Clavicle fractures greater than 2 cm in length often need surgery to prevent issues and improve shoulder function.
Stoppa approach risk
Stoppa approach risk
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Pelvic screw placement
Pelvic screw placement
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Proximal humerus fracture
Proximal humerus fracture
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Shoulder hemi prosthesis height
Shoulder hemi prosthesis height
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Hemiarthroplasty impingement risk
Hemiarthroplasty impingement risk
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Supination-adduction ankle fracture
Supination-adduction ankle fracture
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Sanders IV calcaneus fracture
Sanders IV calcaneus fracture
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Hypertrophic tibial nonunion
Hypertrophic tibial nonunion
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Tibia intramedullary nailing pain
Tibia intramedullary nailing pain
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Femoral neck fracture
Femoral neck fracture
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Iliosacral screw placement risk
Iliosacral screw placement risk
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Nonunion types
Nonunion types
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Humeral shaft fracture
Humeral shaft fracture
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Ulna fracture treatment
Ulna fracture treatment
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Vitamin C and distal radius fracture
Vitamin C and distal radius fracture
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Proximal humerus ORIF complications
Proximal humerus ORIF complications
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Risser sign
Risser sign
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Holstein-Lewis fracture
Holstein-Lewis fracture
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Syme amputation
Syme amputation
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Post-distal radius fracture therapy
Post-distal radius fracture therapy
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Study Notes
Clavicle and Fracture Management
- Displaced distal clavicle fractures may require small fragment plate fixation and potential coracoclavicular ligament reconstruction to avoid further procedures.
- The Neer classification is utilized for categorizing lateral third distal clavicle fractures.
- Shortened clavicle fractures greater than 2 cm warrant surgical management to reduce nonunion and malunion risks while improving shoulder function.
Pelvic and Sacral Injuries
- L5 nerve root is at risk with retractor placement during Stoppa approach for combined acetabulum-pelvic surgeries.
- Anteroposterior and outlet obturator oblique views are crucial for ensuring proper screw placement in the pubic ramus.
Humeral and Shoulder Injuries
- Comminuted proximal humerus fractures are typically treated with shoulder hemiarthroplasty.
- Optimal height for shoulder hemi prosthesis is determined by measuring from the superior border of the pectoralis major insertion.
- Risk of impingement is present when the humeral head is positioned incorrectly during hemiarthroplasty.
Ankle and Foot Trauma
- Supination-adduction ankle fractures involve anteromedial marginal impaction and often require an anteromedial surgical approach.
- Treatment for Sanders IV intra-articular calcaneus fractures with subtalar joint incongruence includes distraction bone block subtalar arthrodesis to restore hindfoot height and correct relationships.
Tibial and Femoral Injuries
- Treatment for hypertrophic diaphyseal tibial nonunion is often isolated exchange reamed interlocking nailing, boasting a high success rate.
- Anterior knee pain following intramedullary nailing of the tibia occurs in 50-75% of cases.
- Bipolar hemiarthroplasty is indicated for displaced femoral neck fractures.
Nerve Risks and Nonunions
- Ipsilateral L5 nerve root injury can result from improper placement of iliosacral screws penetrating sacral ala.
- Various nonunion types include oligotrophic, atrophic, infected, and hypertrophic nonunions.
Surgical Indications and Outcomes
- Absolute surgical indications for humeral shaft fractures include open fractures, vascular injuries, floating elbow, and intra-articular extension.
- Non-operative management is often suitable for certain ulna fractures that are distal two-thirds.
- Vitamin C administration is linked to lower rates of complex regional pain syndrome in distal radius fracture cases.
Complications and Fracture Classifications
- Complexities such as intra-articular screw penetration are common in proximal humerus ORIF procedures.
- Risser sign grades (0-V) indicate the stages of skeletal maturation in children, with Risser 0 correlating with the peak growth velocity.
- Holstein-Lewis fractures refer to distal humeral fractures leading to radial nerve entrapment, with most cases resolving spontaneously.
Amputation Procedures
- Syme amputation enables terminal weight-bearing but is contraindicated if the ABI is below 0.5 for the posterior tibial artery.
Pain Management and Physical Therapy
- Formal physical therapy post-distal radius fracture ORIF shows no significant benefits compared to patient-guided home exercise programs.
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