2017 SAQ Flashcards
1
Q
List 6 etiologies associated with sclerosing periosteal reaction and cortical thickening in infancy and young children
A
- Chronic infection – osteomyelitis
- osteoid osteoma
- chronic stress reaction/fracture
- other tumours – osteosarcoma, Ewing’s sarcoma
2
Q
Define the following: complete, complex, synonychia
A
- Synonychia – fingers share a common nail
- Complete – fusion of digits from webspace to fingertips (simple or complex)
- Complex – involves fusion of bone or finger nails to adjacent fingers
3
Q
When treating a transverse femoral fracture in a child, what are 4 surgical technique considerations to prevent failure of implant fixation and loss of reduction
A
- Flexible nails – nail size – multiply width of canal by 0.4 for diameter of each nail; use only if fracture is midshaft (not as good proximal or distal); don’t use in patients >11 years old or over 50 kg
- Submuscular bridge plating – long 12-16 hole 4.5mm narrow LCDC plate, restrict WB until callus formation
- Antegrade nail – lateral entry (if GT entry used – can get narrowing of femoral neck, premature fusion of GT apophysis, coxa valga, hip subluxation)
4
Q
List 4 indications for operating on the cervical spine in a RA patient
A
- Progressive neurological deficit/myelopathy
- PADI <14mm
- Basilar invagination/ atlantoaxial impaction 5mm above McGregor’s line (hard palate to opisthion)
- Subaxial sagittal canal diameter <14mm
- Chronic neck pain unresponsive to non – narcotic treatment invagination/instability
- ADI >10 mm
- ADI motion >3.5mm on flex-ex
- >7mm with neurological impairment
5
Q
- List the 4 deformities IN ORDER that need to be corrected in clubfoot
A
- CAVE
o Cavus
o Adductus
o Varus
o Equinus
6
Q
- List 8 radiographic findings in aortic dissection
A
- Widened mediastinum
- Hemothorax (left)
- Apical Cap
- Loss of AP window
- Loss of aortic contour/knob
- Tracheal deviation to right
- Deviation of NG to right
- Depression of left bronchus
- Fractured 1st/2nd rib or clavicle
7
Q
- List 6 principles of tendon transfer
A
- Synergistic transfer
- Expandable donor
- Adequate power (lose 1 grade)
- Contractures need releasing
- One tendon, one function
- Adequate amplitude (length/excursion)
- Straight line of pull
- Tissue equilibrium
8
Q
- List 6 orthopedic manifestations that helps in diagnosis of Marfan’s syndrome
A
- Dolichostenomelia (arm span > height >1.05 ratio)
- Arachnodactyly (long, thin toes and fingers)
- Thumb sign (tip of thumb extends beyond small finger when thumb clasped in palm under four fingers)
- Wrist sign (distal phalanges of thumb and index fingers overlap when wrapped around opposite wrist)
- Ligamentous hyperlaxity
- Scoliosis
- Pes planus
- Protrusio acetabuli
- Recurrent dislocations
- Dural ectasia
- Meningocele
- Pectus excavatum or carinatum
9
Q
- List 6 neurologic causes of cavus foot
A
- Charcot-Marie-Tooth
- Stroke
- Spinal cord injury/tumours
- Fredrichs ataxia
- Polio
- Spinal dysraphism
- CP
- Muscular dystrophy
10
Q
- List 5 reduction techniques to use in proximal tibia fractures
A
- Poller screw (blocking screw)
- Suprapatellar approach, semi – extended knee position
- Unicortical plate
- Reduction clamp
- Universal distractor
- Ream reduced
- Avoid anterior start point
11
Q
- List 3 techniques to check for proper femoral rotation during femoral nailing
A
- Match cortices on lateral view
- Lesser trochanter profile
- Clinical assessment
- Fracture fragment reduction
- Tornetta method (CT study for torsion assessment)
12
Q
- List 3 criteria for an acceptable reduction of femoral neck fractures
A
- Restoration of double “s” shape curves on lateral view
- No varus (up to 15 degrees of valgus)
- Reduction of medial calcar with no displacement
- AP angulation < 10 degrees
- Garden alignment index = trabecular liens on AP/lateral (aim for 160/180)
13
Q
- List the 3 findings in sacral sparing
A
- Voluntary anal contraction
- Perianal sensation
- Deep anal pressure
14
Q
- What are 6 relative indications for doing an MRI in scoliosis
A
- Associated back pain
- sign and symptoms of Neurological impairment
- Left sided curve (concave to right)
- Double curves or high thoracic curves
- Spinal X-ray abnormalities aside from curve
- Midline spinal cutaneous markers = dermal tracts, tufts of skin tags, hairy patch
- Abnormal number of café-au-lait spots
- Rapid progression
- Excessive kyphosis
- Foot deformities
15
Q
- List 3 local adverse effects of metal-on-metal hip arthroplasty
A
- Pseudotumour
- Aseptic lymphocyte = dominated vasculitis associated lesion (ALVAL)
- Abductor destruction
- Periprosthetic fracture
- Aseptic loosening
16
Q
- List 4 surgical considerations to take into account when doing a total shoulder arthroplasty in a B2 glenoid (biconcavity)
A
- Patient specific instrumentation = significant bone loss and retroversion
- Preopreative planning with 3D CT = important predictor of appropriate glenoid placement
- asymmetric reaming = can address posterior bone loss up to 5 to 8mm from joint line and correct 10 to 15 degrees of version
- TSA with bone grafting
- TSA with augmented glenoid components
