Questions and Answers
What is Gustilo-Anderson Classification and the recommended antibiotics for each category?
- < 1cm - Ancef (clean wound); 2. > 1 cm - Adequate soft tissue coverage Ancef + Clinda; 3. Extensive soft tissue loss and comminution - Ancef + Clinda + Aminoglycoside; 3A - adequate periosteal coverage but not soft tissue; 3B - >10cm, excessive soft tissue damage & periosteal stripping, contaminated; 3C - arterial compromise. Add PCN G if farm injury (clostridium).
What compartmental pressure merits fasciotomy and what is the name of the device used?
30 mmHg; Wick Catheter.
What are the 6 P's of compartment syndrome?
Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Pressure.
What is the Rosenthal Classification?
Signup and view all the answers
What is the Jahss Classification?
Signup and view all the answers
What is agenesis of the fibular sesamoid called?
Signup and view all the answers
What is the Stewart classification for Jones fractures?
Signup and view all the answers
When should you fixate a Jones fracture?
Signup and view all the answers
What is the TORG classification for Jones fractures?
Signup and view all the answers
What is the most common bone to have a stress fracture?
Signup and view all the answers
What is the Quenu & Kuss classification for Lisfranc dislocations?
Signup and view all the answers
ORIF is indicated for a displacement of ________ between the 1st and 2nd metatarsals in a Lisfranc injury.
Signup and view all the answers
What is the Hardcastle classification for Lisfranc dislocations?
Signup and view all the answers
What is the Watson Jones classification for navicular fractures?
Signup and view all the answers
Watson-Jones type 1 is associated with what other bone injury?
Signup and view all the answers
How much displacement is needed for ORIF in a Cuboid fracture?
Signup and view all the answers
What artery supplies most of the talar body?
Signup and view all the answers
What is the Hawkin's classification for talar neck fractures?
Signup and view all the answers
Is Hawkin's sign sclerotic or radiolucent?
Signup and view all the answers
What is the Sneppen classification for talar body fractures?
Signup and view all the answers
What does pain with forced plantarflexion of the hallux indicate?
Signup and view all the answers
What is the Berndt and Hardy Classification for talar dome fractures?
Signup and view all the answers
What is the Kuwada classification for Achilles tendon rupture?
Signup and view all the answers
Study Notes
Trauma Classifications
Gustilo-Anderson Classification
- Classifies open fractures based on soft tissue involvement and contamination.
- Recommended antibiotics:
- Type I: Wound < 1 cm, Ancef.
- Type II: Wound > 1 cm, Ancef + Clindamycin for adequate soft tissue coverage.
-
Type III: Extensive soft tissue loss.
- 3A: Adequate periosteal coverage.
- 3B: >10 cm excessive soft tissue damage; contaminated.
- 3C: Arterial compromise, Ancef + Clindamycin + aminoglycoside.
- Add Penicillin G for farm injuries (risk of clostridium).
Compartment Syndrome
- Fasciotomy indicated for compartment pressure > 30 mmHg.
- Measurement can be done with a Wick Catheter.
6P's of Compartment Syndrome
- Symptoms include:
- Pain
- Pallor
- Pulselessness
- Paresthesia
- Paralysis
- Pressure
Rosenthal Classification
- Used for digital trauma:
- Type 1: Injury distal to distal phalanx with tissue damage.
- Type 2: Injury distal to lunula (involving Atasoy V-Y or Kutler V-Y flap).
- Type 3: Injury distal to hallux IPJ or lesser DIPJ, often requiring amputation.
Jahss Classification
- Focuses on hallux dislocations:
- Type I: Dorsal dislocation without fracture, challenging reduction.
- Type 2A: Dorsal dislocation with ruptured sesamoid ligament, no fracture.
- Type 2B: Dorsal dislocation with intersesamoid ligament rupture and at least one sesamoid fracture.
- Type 2 Variant: Dorsal dislocation with separation of bipartite sesamoid.
Ilfeld's Disease
- Refers to agenesis of the fibular sesamoid.
Stewart Classification
- Categorizes Jones fractures:
- Type 1: True Jones at the metadiaphyseal-diaphyseal junction.
- Type 2: Intra-articular avulsion fracture.
- Type 3: Extra-articular avulsion fracture.
- Type 4: Intra-articular comminuted fracture.
- Type 5: Extra-articular apophyseal fracture.
- Mnemonic: EIEIO.
Jones Fracture Treatment
- ORIF indicated for fractures with > 5 mm displacement or Stewart Type 4.
TORG Classification
- Radiographic classification for Jones fractures:
- Acute Injury: Sharp fracture margins, minimal bone hypertrophy.
- Delayed Union: Widened fracture line with adjacent radiolucency (bone resorption).
- Non-Union: Obliteration of the medullary canal.
Stress Fractures
- Most common site for stress fractures is the 2nd metatarsal.
Quenu & Kuss Classification
- Classifies Lisfranc dislocations:
- Type 1: Homolateral.
- Type 2: Isolated (1st ray medial).
- Type 3: Divergent.
- Mnemonic: HID.
Lisfranc Injury Fixation
- ORIF indicated for Lisfranc injuries with > 2 mm displacement between the 1st and 2nd metatarsals.
Hardcastle Classification
- Classifies Lisfranc dislocations:
- Type A: Total incongruity.
-
Type B: Partial incongruity.
- B1: 1st met medial.
- B2: Lesser metatarsals lateral.
- Type C: Divergent alignments.
Watson-Jones Classification
- Classifies navicular fractures:
- Type 1: Navicular tuberosity fracture.
- Type 2: Dorsal lip avulsion.
- Type 3: Navicular body fractures with various subtypes.
- Type 4: Navicular stress fracture.
Cuboid Fracture Association
- Watson-Jones Type 1 is associated with cuboid (nutcracker) fractures, requiring ORIF for > 5 mm displacement.
Talar Body and Neck Fractures
- Most of the talar body is supplied by the artery of the tarsal canal.
-
Hawkin's Classification for talar neck fractures indicates risk of avascular necrosis (AVN):
- Type I: Non-displaced (0-13% AVN).
- Type II: Displaced with subtalar joint dislocation (50% AVN).
- Type III: Displaced with ankle dislocation (95% AVN).
- Type IV: Displaced with talonavicular dislocation (95% AVN).
Hawkin's Sign
- Radiolucent sign indicating intact vascularity of the talus noted 6-8 weeks post-fracture.
Sneppen Classification
- Classifies talar body fractures:
- Type 1: Osteochondral fracture.
- Type 2: Various body fracture configurations.
- Type 3: Posterior tubercle fracture.
- Type 4: Lateral process fracture.
- Type 5: Crush fracture.
Talar Tubercle Fractures
- Pain with forced plantar flexion of the hallux suggests a fracture of the posterior tubercle of the talus.
Berndt and Hardy Classification
- Focuses on osteochondral defects (OCDs) in the talus with four types, ranging from compression fractures to complete displaced OCD fractures.
Kuwada Classification
- Used for Achilles tendon ruptures, categorizing partial and full tears.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on the Gustilo-Anderson Classification and its recommended antibiotic treatments for different trauma categories. This quiz is designed to reinforce key concepts in trauma classifications and their clinical implications.
