4th Year Lower Limb

Question 1

what classification is used for intra-capsular NOF fractures?

Answer 1

Garden classification

Question 2

garden classificaiton

Answer 2

1= incomplete fracture and non-displaced
2= complete fracture and non-displaced
3= partial displacement (trabeculae at angle)
4= full displacement (parallel)

Question 3

management of intra-capsular fractures

Answer 3

THR

hemiarthroplasty

Question 4

management of inter-trochanteric

Answer 4

DHS

Question 5

management of subtrochanteric

Answer 5

IM nail

Question 6

what is an inter-trochanteric fracture?

Answer 6

between greater and lesser trochanter

Question 7

what is a sub-trochanteric fracture?

Answer 7

within 5cm below lesser trochanter

Question 8

position of leg in NOF fracture

Answer 8

external rotation due to gluteal muscle bulk

Question 9

position of leg in dislocation

Answer 9

internal rotation

Question 10

criteria to meet for THR

Answer 10

cognition
baseline mobility (no more than 1 stick)
fitness
age/longevity of replacement

Question 11

what do ankle fractures involve?

Answer 11

distal fibula (lateral malleolus)
distal tibia (medial malleolus)

Question 12

what is important for stability at the ankle?

Answer 12

tibiofibular syndesmosis

Question 13

classification used for ankle fractures

Answer 13

Danis-Weber

Question 14

Danis-Weber classification for ankle fractures

Answer 14

A= below ankle joint, syndesmosis intact (brace, cast or moonboot)
B= level of ankle joint, partially torn (operative fixation if talar shift)
C= above ankle joint, disrupted (operative)

Question 15

what is meralgia paraesthetica?

Answer 15

compression of lateral cutaneous nerve of the thigh

Question 16

where does the lateral cutaneous nerve of the thigh nerve roots?

Answer 16

L1,2,3

Question 17

pathway of the lateral cutaneous nerve of the thigh?

Answer 17

behind psoas

under inguinal ligament medial and inferior to ASIS

Question 18

presentation of meralgia paraesthetica

Answer 18

sensory symptoms on outer thigh
hair loss
no motor
symptoms improve on sitting and worsen on hip extension

Question 19

Ottowa’s criteria for XR in mensical tear

Answer 19

>55
patella tenderness
fibular head tenderness
cannot flex knee
cannot take 4 steps

Question 20

GOLD standard for diagnosing ACL rupture?

Answer 20

arthroscopy

Question 21

management of ACL rupture?

Answer 21

reconstruction

conservative with physio if not active

Question 22

options for grafts for the ACL

Answer 22

hamstring tendon
quadriceps tendon
patellar tendon

Question 23

two types of achilles tendonitis

Answer 23

1. insertion tendinopathy= within 2cm of calcaneus

2. mid-portion tendinopathy= 2-6cm above insertion on calcaneus

Question 24

what can steroid injections into plantar fasciitis cause?

Answer 24

atrophy of the fat pad

measure fat pad on USS

Question 25

what do ankle fractures involve?

Answer 25

``` distal fibula (lateral malleolus) distal tibia (medial malleolus ```

Question 26

what is an important structure in the ankle for stability?

Answer 26

tibiofibular syndesmosis

Question 27

classification for ankle fractures

Answer 27

Danis-Weber

Question 28

Danis-Weber classification of ankle fractures

Answer 28

``` A= below ankle joint, syndesmosis intact B= level of ankle joint, partially torn C= above joint, disrupted ```

Question 29

management of A ankle fractures

Answer 29

ankle support brace cast moonboot

Question 30

management of B ankle fractures

Answer 30

operation if talar shift

Question 31

management of C ankle fractures

Answer 31

operative

Question 32

management of tibial shaft fractures

Answer 32

``` conservative= above knee cast operative= IM nail or ORIF ```

Question 33

what are tibial plateau fractures associated with?

Answer 33

soft tissue injuries at the knee, popliteal artery and peroneal nerve risks

Question 34

femoral shaft fracture management

Answer 34

most likely never conservative, but can use Thomas splint | IM nail or ORIF

Question 35

what is the initial management of a pelvic fracture?

Answer 35

pelvic binder

Question 36

classification fo pelvic fractures

Answer 36

young-Burgess (LC, APC and sheer)