Basics of Orthopaedics Flashcards
Define allograft bone?
Bone from human donor other than patient
Define reduction?
Maneuver to restore proper alignment to fracture or joint
Define closed reduction?
Reduction done without surgery
e.g., casts, splints
Define open reduction?
Surgical reduction
Define fixation?
Stabilization of a fracture after reduction by means of surgical placement of
hardware that can be external or internal
e.g., pins, plates, screws
What is a tibial pin?
Pin placed in the tibia for treating femur or pelvic fractures by applying skeletal traction
What is an unstable fracture or dislocation?
Fracture or dislocation in which further deformation will occur if reduction is not performed
What is varus deformity?
Extremity abnormality with apex of defect pointed away from midline
e.g. genu varum = bowlegged
Note: with valgus, this term can also be used to describe fracture displacement
(Think: knees are very varied apart)
What is a valgus deformity?
Extremity abnormality with apex of defect pointed toward the midline
e.g. genu valgus = knock-kneed
What is a dislocation?
Total loss of congruity (no part of the articular surfaces of the bones contributing to the joint are touching each other) and contact between articular surfaces of a joint
What is subluxation?
Loss of congruity between articular surfaces of a joint; articular contact remains
What is arthroplasty?
total joint replacement
What is arthrodesis?
Joint fusion with removal of articular surfaces
What is an osteotomy?
Cutting bone (usually wedge resection) to help realigning of joint surfaces
What is non-union?
Failure of fractured bone ends to fuse
Define diaphysis?
main shaft of long bone
What is metaphysis?
flared end of long bone
What is physis?
Growth plate, found only in immature bone
What is an epiphysis?
the end of a long bone, initially growing separately from the shaft
Define extremity examination in fractured extremities?
- Observe entire extremity
e.g. open, angulation, joint disruption - Neurologic
e.g. sensation, movement - Vascular
e.g. pulses, cap refill
Which x-rays should be obtained?
Two views (also joint above and below fracture)
1. full front view
2. lateral view
How are fractures described?
- Skin status
- open or closed - Bone
by thirds: proximal/middle/distal - Pattern of fracture
e.g. comminuted - Alignment
- displacement, angulation, malrotation, shortening
How do you define the degree of angulation, displacement, or both?
Define lateral/medial/anterior/posterior displacement and angulation of the distal fragment(s) in relation to the proximal bone
What is an open fracture?
Wound overlying fracture, through which fracture fragments are in continuity with outside environment; high risk of infection
What is a simple fracture?
One fracture line, two bone fragments
What is a comminuted fracture?
Results in more than two bone fragments
a.k.a. “fragmentation”
What is a segmental fracture?
Two complete fractures with a “segment” in between
What is an oblique fracture?
Fracture line creates an oblique angle with long axis of bone
Note: >30 degrees
What is a spiral fracture?
Severe oblique fracture in which fracture plane rotates along the long axis of bone
- caused by a twisting injury
What is an impacted fracture?
Fracture resulting from compressive force
- end of bone is driven into contiguous metaphyseal region without displacement
What is a pathologic fracture?
Fracture through abnormal bone
e.g., tumor-laden or osteoporotic bone
What is a stress fracture?
Fracture in normal bone from cyclic loading on bone
- a break that occurs from repetitive motion or strain
What is a greenstick fracture?
Incomplete fracture in which cortex on only one side is disrupted
- seen in children
What is a torus fracture?
Impaction injury in children in which cortex is buckled but not disrupted
(a.k.a. “buckle fracture”)
Avulsion fracture?
Fracture in which tendon is pulled from bone, carrying with it a bone chip
Periarticular fracture?
Fracture close to but not involving the joint
Note: can heal through secondary bone healing
Intra-articular fracture?
Fracture through the articular surface of a bone
- usually requires ORIF: open reduction and internal fixation
Note: requires healing through primary bone healing
Nightstick fracture?
ulnar fracture
Transcervical fracture?
Fracture through the neck of the femur
Tibial plateau fracture?
Intra-articular fracture of the proximal tibia (the plateau is the flared proximal end)
Monteggia fracture?
Fracture of the proximal third of the ulna with dislocation of the radial head
- more common in children and rare in adults
Galeazzi fracture?
Fracture of the radius at the junction of the middle and distal thirds accompanied by disruption of the distal radioulnar joint
- fall on outstretched hand
Tibial “plateau” fracture?
Proximal tibial fracture
Pott’s fracture?
Fracture of distal fibula
Whats Pott’s disease?
Tuberculosis of the spine
What classifies an orthopedic patient?
- Trauma
- Tumours
- Infections
- Joint diseases
- Metabolic diseases
- Congenital abnormality
What does orthopedics do?
- Restoring function to patients
- Maximising function
- Team approach
Whats important to note in trauma?
Mechanism of injury
1. Time of accident
2. Other casualties - assess severity of the accident
3. Other injuries
Important things to note in history taking?
- Occupation of patient
- Handedness
- Past medical history
What is to note under pain in history taking?
- Type
- Location
- Duration
- Exacerbating and relieving factors
- Functional limitation
Examination?
- Look
- Feel
- Move
Look? (Orthopedic exam)
- Gait
- Function
- Posture
- Muscle wasting
- Deformity
- Swelling
- Colour of skin
- Old scars, sinuses
Feel?
- Temperature
- Tenderness
- Mass/ swelling (all the characteristics)
- Joint effusions
