14578142
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 6 years ago
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| Question | Answer |
| 1. TRUE/FALSE? A. Shoulder dislocations are common under 10 years of age. | False. Shoulder dislocations are very rare in this age group. A proximal humeral fracture is more likely. |
| 1. TRUE/FALSE? B. Bone overgrowth is sometimes a problem in children after femoral fractures without growth plate damage. | True. Fractures near but not in the growth plate may lead to overgrowth. Fractures involving the growth plate may result in problems relating to shortening or angulation deformity. These fractures need urgent orthopaedic review and appropriate timely management. |
| 1. TRUE/FALSE? C. An angular metaphyseal deformity of 20 degrees will remodel in a 14 year old girl. | False. For fracture remodelling to correct angular deformity at least 2 years of remaining growth is required ie. age less than 14 years for boys and less than 12 years for girls. |
| 1. TRUE/FALSE? D. Intra-articular fractures need to be reviewed urgently by an orthopedic specialist. | True. Intra-articular fractures (eg. Salter Harris type 3 and 4) are an emergency and need to be reviewed urgently by an orthopaedic specialist. If not treated appropriately they may result in non union, deformity or joint damage. |
| 1. TRUE/FALSE? E. The periosteum in children is not biologically active. | False. A child’s periosteum is extremely biologically active and very rapidly produces new bone. |
| 2. TRUE/FALSE? A. A pulled elbow is due to fracture of the radial head. | False. Pulled elbow is due to subluxation of the radial head from the annular ligament. |
| 2. TRUE/FALSE? B. A pulled elbow that is irreducible needs operative reduction. | False. All pulled elbows resolve in two to three days if left in a sling in case initial attempt at relocation is unsuccessful. However it is important to ensure that other some pathology (eg. septic arthritis of the elbow/wrist, olecranon fracture, and osteomyelitis) is not being mistaken for pulled elbow. A diagnosis of pulled elbow must not be made without a clear history of that elbow being pulled. |
| 2. TRUE/FALSE? C. In a suspected limb fracture always x-ray the joint above and below. | True. This will ensure the entire bone is visualized, and also allow for detection of any joint dislocations. |
| 2. TRUE/FALSE? D. Reduction of a fracture or dislocation should never be attempted without first giving adequate analgesia. | False. Reduction of a fracture without prior administration of analgesia may be attempted in the emergency situation where the displacement of the fracture or dislocation has, or will soon, compromise the neurovascular status of the limb or the viability of the overlying skin. |
| 3. TRUE/FALSE? A. Prompt antibiotic cover and minimal handling are important steps to prevent infection in an open (compound) fracture. | True. Avoid repeated examinations in cases of compound fractures as repeated exposure of the wound promotes bacterial contamination. Also ensure tetanus prophylaxis. Small (puncture) wounds may get missed so a careful initial examination is important. Also suspect compound fracture if air is seen in the tissue planes on x-ray. |
| 3. TRUE/FALSE? B. Supracondylar humeral fracture can damage the brachial artery. | True. It is important to check for the radial pulse and perfusion of the limb distal to the fracture. |
| 3. TRUE/FALSE? C. Supracondylar humeral fracture can damage the anterior interosseous nerve. | True. The anterior interosseous nerve is the most commonly injured in supracondylar humeral fracture. The median, ulnar and radial nerves can also be injured. |
| 3. TRUE/FALSE? D. Rib fractures are common in children. | False. Rib fractures are unusual in children; always consider the possibility of non accidental injury. |
| 4. TRUE/FALSE? A. Spiral fractures are due to a direct blow to the site. | False. Spiral fractures are due to a twisting injury rather than a direct blow. |
| 4. TRUE/FALSE? B. The Salter-Harris classification describes the severity of growth plate fracture. | False. The Salter-Harris classification describes the pattern of growth plate fracture. |
| 4. TRUE/FALSE? C. Spiral fractures of the tibia in toddlers are very suspicious of non accidental injury. | False. Spiral fractures of the tibia are common injuries in toddlers (toddler’s fractures), often caused by tripping on the floor and may not necessarily suggest child abuse. However they may also be a result of NAI (a twisting force applied to the limb). Beware if the history is not plausible or there is unusual delay in seeking treatment or in case of a spiral fracture in an infant who is not as yet walking. |
| 4. TRUE/FALSE? D. Fracture displacement traditionally refers to the bone proximal to the fracture. | False. Displacement is traditionally described with respect to the bone distal to the fracture. |
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