OrthoNet

MCQs-trauma 3
screws and a buttress plate

- the iliac oblique view assesses the posterior column and anterior wall; the obturator oblique view assesses the anterior column and posterior wall, and you see the spur sign on the obturator oblique

- the teardrop is made up medially by the quadrilateral plate, and the anterior acetabular fossa laterally.

- the Chiari osteotomy depends on metaplasia

- the Pemberton osteotomy actually cuts around the acetabulum and hinges it on the tri-radiate cartilage.

- signs of instability in pelvic trauma include symphyseal widening greater than 2.5 cm, and clinical instability.

- the most common cause of cardiac dysrhythmia after citrated massive transfusion is hypocalcemia

- for the metabolic reaction to trauma - serum pyruvate DOES NOT increase. Serum carbonate, lactate, urinary urea excretion, blood glucose all increase.

- remember that the MESS evaluates soft tissue injury, hypotension, ischemia (and ischemia time), and age. So an injury to the tibial nerve, warm ischemia time >6 hours, age >60, and a MESS score of over 7 is predictive of amputation. Segmental bone loss does not predict amputation.

- remember to do the fasciotomies after vascular injury to the limb

- if you choose a starting point too anterior and lateral for starting an IM nail, the fracture will heal in VARUS.

- be wary of using an IM rod to manage the fibular fracture of a pilon injury - you need some rotational stability, and the IM rod will not give you this.

- fix the humeral shaft fracture of the polytraumatized patient - IM nail, or ORIF

- for tibial shaft fracture in cast: 5o of varus/valgus, 10 of flex/ext, up to 5 mm shortening, no rotation is acceptable.

- if you see callus around a plate, the plate is probably abit loose

- an upper tibial injury with bone exposed is probably a Gustillo IIIB injury (will need a flap)

- a deep posterior compartment syndrome has pain on passive extension of the toes