Treatment of Colles Fracture - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 02-04-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Rheumatology/Orthopedics Treatment of Colles Fracture

A 70-year-old woman was walking across her kitchen when she tripped over a throw rug and fell onto her outstretched right hand. She did not hit her head or lose consciousness. She had immediate pain and swelling in her right wrist and was brought to the emergency department by her daughter. X-ray of the right wrist reveals a dorsally displaced, dorsally angulated fracture of the distal radius with a displaced intra-articular fragment in the radiocarpal joint.
There was no break in the skin. The patient is otherwise healthy, and her past medical history is significant only for a T11 compression fracture 2 years ago. Which of the following is the most appropriate treatment?
(A) Closed reduction and arm sling
(B) Closed reduction and long arm cast
(C) Ice and compressive bandage
(D) Open reduction and internal fixation
(E) Physical therapy and night splint

Please give reasoning for the answer.
Reply With Quote Quick reply to this message



  #2  
Old 02-04-2012
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 22
Threads: 5
Thanked 61 Times in 13 Posts
Reputation: 71
Default

B - closed reduction with long arm cast

thats because the q didnt say anything about vascular/neurological damage or addional mangled-ness, so it does not need operation.

long arm - because both the radius and ulna are special and are actually involved in two joints that are really mobile (proximal and distal radio-ulnar). and you are supposed to put a cast on so that the bones before and after the joint are immobilized. and here, we have two joints that should be immobilized so thats why the cast needs to be a longer one. Plus its an older lady but she is not that old, so you want it to heal as well as possible for the best function but unfortunately she is not a teenager so bones don't heal as fast.

also screen for osteoporosis.

hope this helps!
Reply With Quote Quick reply to this message
  #3  
Old 02-04-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Default

Quote:
Originally Posted by nyuszi View Post
B - closed reduction with long arm cast
this is not the correct ans.
Reply With Quote Quick reply to this message
 
  #4  
Old 02-04-2012
USMLE Forums Scout
 
Steps History: 1+CK+CS+3
Posts: 14
Threads: 5
Thanked 2 Times in 2 Posts
Reputation: 12
Default

X-ray of the right wrist reveals
a dorsally displaced, dorsally angulated fracture
of the distal radius with a displaced intraarticular
fragment in the radiocarpal joint.
There was no break in the skin. The patient is
otherwise healthy, and her past medical history
is signifi cant only for a T11 compression fracture
2 years ago. Which of the following is the
most appropriate treatment?
(A) Closed reduction and arm sling
(B) Closed reduction and long arm cast
(C) Ice and compressive bandage
(D) Open reduction and internal fixation
(E) Physical therapy and night splint

The answer is D.

Displaced intraarticular fracture is an indication for surgery in an other-wise healthy elderly. This is required to maintain joint congruity which may not be accurately obtained with long arm cast.
Reply With Quote Quick reply to this message
The above post was thanked by:
HouseWannabe (02-05-2012)
  #5  
Old 02-04-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Default

@ dr ortho

wow...thats correct...B...and ditto explanation..are you orthopedician , by the way?
i had just crammed closed reduction for colles...but man, u need to think every q.
Reply With Quote Quick reply to this message



Reply

Tags
Orthopedics-, Step-1-Questions, Surgery-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
CCS- femure neck fracture meduploader USMLE Step 3 Forum 0 09-22-2011 05:15 AM
Management of Fracture Clavicle USMLE-Syndrome USMLE Step 2 CK Forum 4 08-17-2011 07:05 AM
Sequelae of Fracture drgsarunprasath USMLE Step 1 Forum 8 08-15-2011 02:53 AM
clavicular fracture busterbee USMLE Step 2 CK Forum 7 08-12-2011 06:56 AM
The best next step for this pelvic fracture aksyonez USMLE Step 2 CK Forum 5 07-19-2011 12:37 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)