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121 visible knowledge nodes in trauma
5th Metatarsal Base — Zones (Pseudo-Jones/Jones/Stress)
Zone I: tuberosity avulsion (pseudo-Jones) — usually heals conservatively. Zone II: Jones fracture at metaphyseal–diaphyseal junction — watershed area, higher nonunion → screw fixation esp. athletes. Zone III: proximal diaphyseal stress fracture — often needs surgery + graft in chronic cases.
Open topicAC Joint Injuries — Rockwood
Rockwood I–VI classification based on AC/CC ligament disruption and clavicle displacement. I–II: non-op (sling, rehab). III: controversial; IV–VI: surgery. Surgical options: hook plate, CC fixation (suture buttons), ligament reconstruction (Weaver‑Dunn/hamstring graft). Complications: hardware irritation, loss of reduction, osteolysis. Rehab: early ROM; contact sports after strength and stability return.
Open topicAcetabular Fractures — Letournel
Elementary: PW, PC, AW, AC, Transverse. Associated: PC+PW, Trans+PW, T-type, AC+PHT, Both-column. Views: Judet + CT 3D. Approaches: KL (post), Ilioinguinal/Stoppa (ant). Goal: anatomical reduction ≤2 mm dome.
Open topicACL Injury — Biomechanics, Diagnosis & Reconstruction Principles
Comprehensive guide to anterior cruciate ligament injury covering anatomy, biomechanics, clinical diagnosis including Lachman and pivot shift tests, graft selection, fixation methods, and evidence-based return-to-sport criteria.
Open topicAllman / Neer Distal Third — Clavicle
Allman: Type I midshaft; Type II distal; Type III medial third. Neer distal clavicle: Type I stable; IIA/IIB unstable (CC ligaments disrupted); Type III intra-articular; V epiphyseal. Distal (Neer IIB) has high nonunion; often operative.
Open topicAnderson–D’Alonzo — Odontoid (Dens) Fractures
Type I: tip avulsion (rare, stable). Type II: base of dens (common, unstable, high nonunion). Type III: into C2 body (better healing).
Open topicAnkle Fractures — Lauge-Hansen
Classification based on position of foot + force direction. Common: Supination-External Rotation (SER), Supination-Adduction (SA), Pronation-Abduction (PA), Pronation-External Rotation (PER). Each mechanism has progressive stages of injury (ligament/osseous). Guides mechanism-based diagnosis and fixation strategy. Supination-External Rotation = most common ankle injury.
Open topicAO Spine Thoracolumbar Classification
Type A (compression): A1 wedge, A2 split, A3 incomplete burst, A4 complete burst. Type B (tension band): B1 posterior through bone/ligament, B2 posterior + anterior, B3 anterior hyperextension. Type C (translation/rotation): multidirectional instability. Neurologic grade (N0–N4) and modifiers guide treatment.
Open topicAO/OTA 33 — Distal Femur (Supracondylar)
33-A: extra-articular; 33-B: partial articular (e.g., Hoffa = B3); 33-C: complete articular. Articular types require anatomic joint reduction; fixation usually with locking plates or retrograde nails.
Open topicAO/OTA 41 — Proximal Tibia (Alternative to Schatzker)
41-A extra-articular; 41-B partial articular; 41-C complete articular. Complements/updates Schatzker with alphanumeric consistency across regions.
Open topicAO/OTA 42 — Tibial Shaft + Oestern–Tscherne & Gustilo
AO: 42-A simple, 42-B wedge, 42-C complex/segmental. Closed soft tissues graded by Oestern–Tscherne; open injuries by Gustilo (I–IIIC). Guides fixation strategy and antibiotics/coverage planning.
Open topicApproach to Lytic Bone Lesions
A lytic bone lesion on X-ray should be approached systematically using five steps: patient age (the single most powerful clue — under 20 favours benign lesions, over 40 mandates excluding metastasis and myeloma first), location within the bone (epiphysis, metaphysis, or diaphysis each suggest specific diagnoses), zone of transition (narrow/sclerotic rim = benign; permeative = highly aggressive), periosteal reaction (solid = benign; Codman's triangle/sunburst/onion-skin = malignant), and matrix p...
Open topicBado Classification — Monteggia Fracture-Dislocations
I: anterior radial head dislocation (ulna angulated anterior). II: posterior; III: lateral; IV: both bones fractured with radial head dislocation. ORIF ulna restores radial head reduction; direction predicts associated patterns.
Open topicBado Classification (Paediatric) — Monteggia & Equivalents
Type I: Anterior radial head dislocation with anterior angulated ulnar fracture — most common in children. Type II: Posterior/posterolateral dislocation; Type III: Lateral/anterior-lateral dislocation; Type IV: Both-bone fractures + radial head dislocation. Equivalents: Variants with plastic deformation or isolated ulna fracture + radial head dislocation; must realign ulna to reduce radius.
Open topicBiomechanics of Fracture Fixation
Load sharing vs load bearing; absolute vs relative stability; primary vs secondary healing. Plates: compression (DCP/LCP in compression) vs bridging (relative stability); working length matters. Nails: intramedullary load‑sharing devices; reamed vs unreamed; interlocking controls length/rotation. External fixation: pin density/configuration, frame stiffness; circular frames allow controlled micromotion. Screw biomechanics: lag by technique vs design; pull‑out strength depends on cortical engagem...
Open topicBöhler Braun Splint — Set-up
Used for tibia/femur fractures with traction. Has pulleys, slings; allows elevation and adjustment. Complications: sores, stiffness, peroneal palsy.
Open topicBoth Bone Forearm Fractures
Simultaneous fracture of radius and ulna compromises pronation-supination. Adults: ORIF with plating is gold standard; children: closed reduction & casting. Principle: restore length, alignment, rotation of both bones. Complications: malunion, nonunion, radioulnar synostosis.
Open topicBuckle (Torus) & Plastic Bowing — Paediatric Forearm Patterns
Buckle/Torus: Compression failure of cortex (metaphyseal) — stable; treat with short immobilization/splint. Plastic Bowing: Microfracture without discrete break; persistent deformity if not recognized and reduced. Greenstick: One cortex fails in tension, other intact — needs gentle completion or molding to correct alignment.
Open topicCalcaneal Fractures — Sanders & Essex-Lopresti
Sanders classification: based on CT coronal posterior facet fractures. Essex-Lopresti: tongue vs joint depression patterns. Operative indications: displacement >2 mm, malalignment, large fragment involvement. ORIF via extensile lateral or sinus tarsi approach; primary subtalar fusion in severe comminution. Complications: wound breakdown, infection, subtalar arthritis.
Open topicCervical Spine Trauma — Subaxial
Follow ATLS with careful immobilization; CT is first‑line imaging for suspected injury. AO Subaxial classification guides stability and surgical approach; assess disco‑ligamentous injury and neurology. Bilateral facet dislocation: attempt awake traction reduction, then ACDF or posterior fixation depending on disc herniation and stability. Teardrop fractures and burst injuries often need anterior decompression + fixation. Early decompression in incomplete SCI may improve outcomes.
Open topicClavicle Fractures — Management
Most common: midshaft fractures; assess displacement, shortening, comminution, skin tenting, neurovascular status. Nonoperative for minimally displaced; operative indications include >2 cm shortening, 100% displacement, comminution, open injury, skin compromise, floating shoulder, polytrauma. Fixation options: plate (superior/anteroinferior), intramedullary device; lateral third may need coracoclavicular augmentation. Complications: nonunion, malunion with symptomatic shortening, hardware irrita...
Open topicClavicle Nonunion — Plate vs Graft
Symptomatic nonunion: pain, cosmetic deformity, scapular dyskinesis, and weakness. Standard treatment: compression plating + autogenous iliac crest bone graft for atrophic nonunion. Superior vs anteroinferior plating—each has pros/cons (biomechanics vs soft‑tissue irritation). Segmental defects >3 cm or failed revisions may need vascularized graft (fibula). Smoking cessation and vitamin D optimization improve union.
Open topicCompartment Syndrome — Diagnosis and Management
Raised intracompartmental pressure → ischemia/necrosis. Causes: tibia/forearm fractures, crush injury, reperfusion, tight casts. Early signs: pain out of proportion, pain on passive stretch. Diagnostic criteria: CP >30 mmHg or ΔP (DBP–CP)
Open topicCompartment Syndrome — Pressure Criteria
Absolute CP >30 mmHg indicates fasciotomy. ΔP = DBP – CP; if <30 mmHg, fasciotomy indicated. Interpret with clinical signs.
Open topic