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INTRODUCTION

Test Taking Tip

Orthopedics is not usually a high-yield topic for the ABSITE, although they will occasionally ask a question related to trauma. Look over injury patterns and know which fractures are associated with each other (e.g., calcaneal fractures and spinal compression fractures).

TYPES OF FRACTURES

Which type of fracture is characterized by sharp fragments?

  • Acute fractures

What is a callus a sign of?

  • Bone motion; usually the presence of a callus indicates an attempt at healing

What are “greenstick” fractures?

  • Incomplete disruptions of one side of the bony cortex in children; bone can be bent, but not displaced, with greenstick fractures

Which type of fracture occurs through diseased bone (e.g., a tumor or osteopenic bone)?

  • Pathologic fractures

What are fractures called that have a communication to the skin?

  • Open fractures (to be classified as an open fracture, the wound has to be in the same limb segment as the fracture)

What type of fracture is caused by rotational forces?

  • A spiral fracture (usually in the tibia)

What term is given to a fracture that has multiple fragments?

  • A comminuted fracture (usually a sign of a high-energy injury)

What is a “butterfly fragment”?

  • A smaller portion of bone that is separated from the larger portions; implies greater force and a bending mechanism; must be at least 3 fragments

Define a Monteggia fracture:

  • Fracture of the proximal one-third of the ulna with associated dislocation of the radial head

Define a Galeazzi fracture:

  • Fracture of the radius with associated dislocation of the distal radio-ulnar joint

FIGURE 28-1.

Scaphoid fracture: nonunion. (Reproduced with permission from Doherty GM. CURRENT Diagnosis & Treatment Surgery, 15th ed. New York, NY: McGraw Hill; 2020.)

Define a Lisfranc injury:

  • A disruption of the Lisfranc ligament—the ligament binding the medial cuneiform to the second metatarsal base

Scaphoid fractures most commonly occur as a result of:

  • Fall on an outstretched hand

Where does a scaphoid fracture of the wrist classically produce tenderness?

  • Pain on the radial aspect of the wrist with tenderness over the anatomic snuffbox

Define a Chance fracture:

  • A distraction-type injury of the spine where the anterior ligament fails under tension; often caused by a seatbelt injury. There is a high likelihood of associated abdominal injury (∼60%).

Define a Jefferson ...

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