General Orthopedics Flashcards
First imaging method used in osteoarthritis
X-ray
Names of the eight fracture lines
- Oblique
- Transverse
- Spiral
- Comminuted
- Torus
- Greenstick
- Compression
- Stress
Symptoms of osteoarthritis
- Pain (deep, diffuse, aching)
- Stiffness (<30 minutes)
- Deformity eventually
How to describe a fracture where one side of the bone cortex is compressed/bent and the other side is disrupted
Greenstick
Indications for external fixation of a fracture
- Significant soft tissue damage
- Severe swelling
How to describe a fracture where one side of the bone cortex is compressed while the other side remains intact
Torus
Stress fractures are most commonly seen in this area of the body
Lower extremities due to body weight
Three phases of fracture healing and their timeline
- Inflammation - 0 to 2 weeks
- cells migrate to fracture site
- maybe avoid NSAIDs here - Initial repair - 2 to 6 weeks
- callus starts to form - Remodeling - 6 to 10 weeks
- callus replaced by mature bone
Describe delayed union in relation to fractures
- Prolonged healing
- Fracture heals, but it takes twice as long (12-16 weeks)
Four physical exam signs of osteoarthritis
- Tenderness
- Limited ROM
- Effusion (swelling)
- Crepitus (rattling, cracking)
Describe malunion in relation to fractures
Bone heals, but in poor alignment
Pharmacologic treatment of osteoarthritis
- NSAIDs first line
- Topical NSAIDs better if GI/CV/renal concerns
- Acetaminophen (worse than NSAIDs)
- Duloxetine
- Corticosteroid injections
How to describe a fracture where a joint is directly involved
Intra-articular
How to describe a fracture in which there are more than two bone fracture fragments
Comminuted
Indication for open reduction internal fixation (ORIF) of a fracture
Fractures known to heal poorly with nonsurgical treatment (femoral neck fractures)
Types of fractures particularly at risk of impaired healing due to smoking
- Tibial shaft fractures
- Spinal fusions
- Foot/ankle fusions
Four signs of osteoarthritis on x-ray
- Loss of joint space
- Osteophytes (spurs)
- Sclerosing
- Subchondral cysts
How to describe a fracture where the bone fragments of a fracture are no longer in their previous alignment
Displaced
Describe nonunion in relation to fractures
Fracture not healed after six months of treatment
Describe the components of ODELL used to describe fractures
- Open/closed
- Displaced/Nondisplaced
- Extra/intra-articular
- Line
- Location
Nonpharmacologic treatments of osteoarthritis
- Weight loss
- Exercise
(also assist devices, braces, and physical therapy)
Difference between arthroplasty and arthrodesis
- Arthroplasty: replacement of a joint
- Arthrodesis: fusion of a joint
Two biggest risk factors for impaired fracture healing
- Infection
- Smoking
(others: inadequate immobilization, malnutrition, NSAIDs, significant soft tissue injury)
What would be seen on an x-ray of a healing stress fracture
A callous, maybe no visible fracture
