FULL EVALUATION VERIFIED A+
◉ Define Torus fracture (aka buckle fx); Tx?. Answer: one side of the
cortex buckles** as a result of a compression injury -- falling on an
outstretched hand
tx: 4-6 weeks in a cast
◉ Define Green stick fx; Tx?. Answer: long bones -- when bowing*
causes a break in one side of the cortex
tx: <15 degrees -- long arm or leg cast -- 4-6 weeks
> 15 degrees -- referral to an ortho surgeon
◉ What is dislocation?. Answer: total loss of congruity -- between
the articular surfaces of the joint
◉ Most common sites of dislocation are:. Answer: Anterior shoulder
Posterior hip -- osteonecrosis of femoral head
Posterior elbow
,◉ Treatment of dislocations:. Answer: assess neurovascular status --
tx Closed reduction**
reduce spontaneously -- immobolization 2-4 weeks follow by ROM
if fx or interposed soft tissues -- open reduction/internal fixation
assess the neurovascular status pre- and post-, get postreduction
radiographs
◉ Diff between Sprains/strains:. Answer: sPrains -- collagenous
tissues -- Ligament or tendon
sTain -- injury to the Bone-Tendon unit @ myotendinous junction or
the muscle
◉ Sprains or strains injury often follows a sudden stretch; it can lead
to AVULSION of Tendon:. Answer: mallet finger avulsion or stretch of
the terminal extensor tendon -- tx: extensor splinting x6 weeks
◉ It can also lead to Ligamentous sprain:. Answer: stretch of the
anterior talofibular ligament (ATL) -- common ankle sprain**
,◉ Tx for both strains and sprains:. Answer: supportive therapy:
RICES -- rest, ice, compression, elevation, and support/bracing
◉ What is the most common type of fx in children and adolescents?.
Answer: Fx clavicle **
caused by fall on an outstretched arm
tx: kids - figured-of-eight sling -4-6weeks
adults -- sling -6 weeks
◉ Shoulder dislocation:. Answer: fall on outstretched arm -
aBduction/extension
Anterior** shoulder
◉ Dx and Tx of shoulder dislocation:. Answer: Dx: AP view and
transthoracic "Y" view
humeral head deformities= Hill-Sachs lesions - recurrent
dislocations
Tx: reduction, immobilization= sling/swath - Velpeau sling**; <40yo
-- therapy after 3 weeks; >40 - after 1 week
◉ Humeral head* fractures:. Answer: proximal humerus -- OLDER pt
w/osteoporsis/ F
, Neer classification -- ecchymosis x 24-48hrs/pain -greater
tuberosity
early mobilization -pendulum excises -- prevent frozen shoulder
◉ Humeral shaft* fx:. Answer: MVC, fall, penetration injury, gunshot
wounds
*** radial n. damage
◉ Dx and Tx for humeral shaft tx:. Answer: dx: AP and lateral x-ray --
elbow and shoulder
tx: coaptation splint --
hanging cast, Sarmiento brace, or OR
◉ Supracondylar humerus fx:. Answer: all on the outstretched hand
with HYPEREXTENSION of the elbow
** brachial a. -- most spastic artery -- Valkamann ischemic
contractures // varus=gunstock or valgus deformities
◉ Fracture and dislocations of the hand:. Answer: boxer's fx
colles fx