Radial Head Fractures and Mason Classification
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Questions and Answers

Which type of radial head fracture involves minimal displacement?

  • Type IV
  • Type I
  • Type II (correct)
  • Type III

    • What is the most common treatment for a nondisplaced olecranon fracture?

  • Early rehabilitation therapy
  • Acupuncture treatment
  • Surgical fixation
  • Conservative treatment with immobilization (correct)

    • In which classification does a radial head fracture occur alongside an elbow dislocation?

  • Type I
  • Type IV (correct)
  • Type III
  • Type II

    • Which imaging method is typically used to assess comminuted radial head fractures?

    <p>CT scan</p> Signup and view all the answers

    What is a common clinical feature of both radial head and olecranon fractures?

    <p>Swelling and ecchymosis around the elbow</p> Signup and view all the answers

    Which fracture type requires surgical fixation if there is greater than 2-mm displacement or 30% involvement of the radial head?

    <p>Type II</p> Signup and view all the answers

    What population is most at risk for olecranon fractures?

    <p>Elderly individuals</p> Signup and view all the answers

    Which of the following is NOT a feature of a Type III radial head fracture?

    <p>Minimal displacement</p> Signup and view all the answers

    What is the main provocative test for diagnosing de Quervain's tenosynovitis?

    <p>Finkelstein's test</p> Signup and view all the answers

    Which of the following is not considered a treatment option for de Quervain's tenosynovitis?

    <p>Physical therapy</p> Signup and view all the answers

    What is a primary characteristic feature of Intersection syndrome?

    <p>Pain at the intersection of first and second dorsal extensor compartments</p> Signup and view all the answers

    Which activity is most likely associated with the onset of Intersection syndrome?

    <p>Repetitive wrist use in sports</p> Signup and view all the answers

    How is the diagnosis of Intersection syndrome typically confirmed?

    <p>History and clinical examination</p> Signup and view all the answers

    Which of the following treatments is an initial non-surgical solution for Intersection syndrome?

    <p>Rest and activity modification</p> Signup and view all the answers

    What common symptom might indicate de Quervain's tenosynovitis?

    <p>Persistent thumb discomfort</p> Signup and view all the answers

    What is the typical composition of a ganglion cyst?

    <p>Fluid-filled cystic structure</p> Signup and view all the answers

    What is the primary stabilizer of the distal radioulnar joint?

    <p>TFCC</p> Signup and view all the answers

    What is a common mechanism of injury leading to TFCC tears?

    <p>Falling on an outstretched hand</p> Signup and view all the answers

    In younger athletes, what is the typical cause of TFCC tears?

    <p>Single traumatic event</p> Signup and view all the answers

    What imaging technique is essential for evaluating ulnar variance in the context of TFCC injury?

    <p>X-ray</p> Signup and view all the answers

    What is the most effective treatment for an acutely injured central articular disc of the TFCC?

    <p>Surgical debridement</p> Signup and view all the answers

    What is the typical mechanism of injury for a jersey finger?

    <p>Finger caught in an opponent's jersey</p> Signup and view all the answers

    Which of the following clinical features is associated with a mallet finger?

    <p>Inability to flex the DIP joint</p> Signup and view all the answers

    In the context of flexor digitorum injuries, what is true regarding imaging findings?

    <p>Plain X-rays may show an avulsed fragment</p> Signup and view all the answers

    What is the primary characteristic of a Colles’ fracture?

    <p>Fracture of the distal radius with dorsal displacement</p> Signup and view all the answers

    Which condition is characterized by painless nodules in the distal palmar crease?

    <p>Dupuytren's contracture</p> Signup and view all the answers

    What mechanism of injury (MOI) is commonly associated with a Colles’ fracture?

    <p>Fall onto an outstretched arm (FOOSH)</p> Signup and view all the answers

    What distinguishes a Monteggia fracture from a Galleazi fracture?

    <p>Fracture of the ulna with proximal radioulnar dislocation</p> Signup and view all the answers

    Which imaging technique is utilized for diagnosing fractures at the wrist?

    <p>AP and lateral plain films of the wrist</p> Signup and view all the answers

    What deformity is associated with a Colles' fracture?

    <p>Dinner fork deformity</p> Signup and view all the answers

    Which statement accurately describes a Smith's fracture?

    <p>It leads to volar displacement and angulation.</p> Signup and view all the answers

    In Dupuytren's contracture, which finger is most commonly affected?

    <p>Ring finger</p> Signup and view all the answers

    What is a common imaging finding in a case of mallet finger?

    <p>Avulsed fragment of the distal phalanx</p> Signup and view all the answers

    What is the treatment protocol for mallet finger after 6 weeks of splinting?

    <p>Gentle active flexion with night splinting for 2–4 weeks</p> Signup and view all the answers

    Which characteristic is NOT associated with boutonniere deformity?

    <p>Subluxation of the distal phalanx</p> Signup and view all the answers

    Which of the following is a complication of a Bennet’s fracture?

    <p>Subluxation of an avulsed metacarpal fragment</p> Signup and view all the answers

    What distinguishes a Bennet's fracture from a Rolando's fracture?

    <p>Rolando's fracture involves a T, Y, or comminuted configuration</p> Signup and view all the answers

    What initial treatment is recommended for a displaced thumb fracture?

    <p>Orthopedic referral for open reduction and internal fixation</p> Signup and view all the answers

    What clinical feature indicates a mallet finger injury?

    <p>Inability to actively extend the distal interphalangeal joint</p> Signup and view all the answers

    What indicates a severe lesion requiring surgical repair in mallet finger?

    <p>Poor healing despite conservative treatment</p> Signup and view all the answers

    Study Notes

    Radial Head Fracture

    • Radial head fractures often occur alongside elbow dislocation.
    • Mason Classification:
      • Type I: Nondisplaced fracture
      • Type II: Marginal fracture with minimal displacement
      • Type III: Comminuted fracture
      • Type IV: Fracture with elbow dislocation
    • Common mechanism: Fall on outstretched arm.
    • Symptoms include pain, swelling, and decreased range of motion.
    • Treatment:
      • Type I: Conservative management; immobilization for 3-5 days followed by early range of motion exercises.
      • Type II: Surgical fixation if displacement exceeds 2 mm or 30% radial head involvement.
      • Type III: Surgical fixation required.
    • Imaging modalities:
      • Plain X-rays for initial assessment.
      • CT scan for comminuted fractures.
      • MRI if ligamentous injury is suspected.

    Olecranon Fracture

    • Caused by direct trauma to a flexed elbow or a fall on an outstretched arm.
    • Typically affects older adults (mean age ~57 years); bimodal distribution of injury types.
    • Classification (Mayo):
      • Nondisplaced
      • Displaced
    • Symptoms include swelling, ecchymosis, and deformity, with potential ulnar nerve involvement.
    • Imaging: X-ray in A/P, lateral, and oblique views.
    • Treatment:
      • Nondisplaced: Conservative management with cast and early range of motion.
      • Displaced: Surgical intervention (Open Reduction Internal Fixation - ORIF).

    Intersection Syndrome

    • Characterized by irritation of tendon compartments in the wrist, common among athletes.
    • Symptoms include pain at the intersection of first and second dorsal compartments, exacerbated by wrist motion.
    • Diagnosis is confirmed via clinical examination.
    • Initial treatment is non-surgical: NSAIDs, activity modification, and wrist splinting.
    • Surgical intervention may be needed if non-surgical management fails.

    Ganglion Cyst

    • Synovial fluid-filled cysts arising from the synovial sheath of joints.

    Fracture of the Distal Radius

    • Colles' Fracture: Most prevalent; characterized by dorsal displacement and angulation.
    • Smith's Fracture: Volar displacement and angulation; considered the reverse of Colles' fracture.
    • Associated with tears of the triangular fibrocartilage complex (TFCC) and scapholunate dissociation.
    • Symptoms include acute pain and swelling after a fall on an outstretched arm.
    • Imaging includes A/P and lateral plain films of the wrist.
    • Treatment varies based on fracture details, often requiring orthopedic referral for closed reduction.

    Monteggia vs. Galeazzi Fracture

    • Monteggia: Fracture of the ulna with dislocation of the radial head.
    • Galeazzi: Fracture of the radius with dislocation of the distal radioulnar joint.

    Dupuytren's Contracture

    • Thickening and contraction of the palmar fascia, often genetic (common in Northern European descent).
    • Symptoms include painless nodules in the palmar crease, which may become tender.
    • Involved fingers are drawn into flexion, commonly affecting the ring finger.

    Triangular Fibrocartilage Complex (TFCC)

    • Risk factor: Positive ulnar variance.
    • Symptoms: Wrist catching/locking, tenderness in the area beneath the ulnar styloid.
    • Acute injury management often involves surgical debridement; peripheral tears have slower recovery.

    Jersey Finger

    • Injury to the flexor tendon often seen in athletes.
    • Symptoms: Inability to flex the DIP joint actively.
    • Treatment typically involves early surgical repair.

    Mallet Finger

    • Also known as baseball finger; results from sudden passive flexion of the DIP joint.
    • Symptoms: Flexed DIP joint that cannot be actively extended.
    • X-rays may reveal an avulsed fragment of the distal phalanx.
    • Treatment: Conservative splinting of the DIP in extension for 6-8 weeks, with possible surgical intervention.

    Bennet's and Rolando's Fracture

    • Bennet's fracture: Oblique fracture-subluxation at the base of the thumb metacarpal.
    • Rolando's fracture: Fracture at the thumb metacarpal base that can be classified into T, Y, or comminuted types.
    • Imaging: Requires AP lateral and oblique films.
    • Treatment: Conservative for nondisplaced; displaced cases need orthopedic intervention.

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    Description

    This quiz covers the Mason classification of radial head fractures associated with elbow dislocations. It includes details on different types of fractures along with their clinical features and treatment options. Test your knowledge on this important topic in orthopedic practice.

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