Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Orthopaedics and Trauma > Hip and knee > Flashcards

Hip and knee Flashcards

1
Q

Features of hip dislocation presentation

A

90% posterior, normally in high-impact (e.g. RTC)

10% sciatic nerve injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Radiographic features of hip dislocations

A

posterior acetabulum

Head of femur superior to acetabulum

Femur in internal rotation + adduction

Affected femoral head may appear smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which femoral fractures can disrupt blood supply

A

Intracapsular (i.e. proximal to intertrochanteric line)

  • Subcapital, transcervical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of extracapsular #NOF

A

Retain head + neck because blood supply preserved

DHS or intramedullary nail

Medical management of osteoporosis!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Garden classification of femoral fractures

A

1 + 2 better than 3+4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Intracapsular # NOF management options

A

Non-operative: Medically moribund

Operative:

  • Retaining head + neck (3 screws or DHS)
    • Garden I + II, DHS (it rhymes!)
    • More controversial for elderly
  • Replacement:
    • Young, active –> THR
    • Elderly, low functional baseline –> hemiarthroplasty

Medical management of osteoporosis!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Complications of hip replacement

A

Anaesthetic, bleeding, infection

Malunion

Leg length discrepancy

Fat embolus

VTE/pressure sores

Dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Investigation of #NOF

A

Bloods: FBC, U+E, clotting, G+S, LFT

X: AP + lateral hip X-ray, X-rays of other images (incl CT head); CXR

ECG:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complications of internal fixation of fractures

A

Non-union

AVN

Loss of reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Poor prognostic factors for mortality in #NOF

A

Delirium/dementia

Poor social/physical f(x)

Delay in surgery

Post-op chest infection, wound infection

Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of #NOF

A

Chest infection

DVT/PE

Post-traumatic arthritis (related to AVN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Early features of hip OA

A

Exercise-induced groin/anterior-medial thigh pain

Loss of internal rotation

Difficulty bending down e.g. shoelaces

May be referred pain to knee!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentation of greater trochanteric bursitis

A

Tenderness over greater trochanter + pain on lying/walking

Normal ROM

Evidence on US/MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of greater trochanteric bursitis

A

Self-limiting

Steroid injections if recurring

Surgical lengthening of fascia lata/removalof bony spur if intractable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Presentation of avulsion fractures of the hip

A

Young aptients (tendon > bone)

Pain first felt when kicking/twisting against resistance

Tenderness over rectus femoris origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of avulsion fractures

A

Rectus femoris + AIIS

Tendon fascia lata/sartorius + ASIS

Hamstrings + ischium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sources of referred hip pain

A

Lumbar spine spondylosis

Lumbar radiculopathy

Spinal stenosis

Sacro-iliac joint dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mechanism for knee dislocation

A

High-impact e.g. RTC

Low-impact: athletic w/ rotational component, morbid obesity is a risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Associated injuries knee dislocations

A

Vascular (5-15%)

Common peroneal nerve (25%)

Fractures (60%)

Ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Features of patellar dislocation

A

Usually direct blow/sudden twist, often dislocates laterally

Intense pain w/ effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of patellar dislocation

A

Closed reduction

Post-reduction X-ray –> check reduction + for patellar #

Immobilisation in plaster/cast

Rehab w/ quad strengthening exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Causes of recurrent patellar subluxation

A

Tight lateral retinaculum –> pulls knee laterally (medial pain!)

Girls with valgus knees

Patella alta

Joint laxity

Hypotrophic lateral femoral condyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Collateral ligament injury presentation

A

Valgus/varus stress on knee (direct blow on fixed foot)

Effusion + tenderness over affected ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Management of knee collateral ligament tear

A

Medial (more common) > normally managed conservatively (rest + support in hinged knee brace)

Lateral may need surgery if unstable/other ligamentous injury

25
Cruciate ligament tear presentation
Twisting injury to the knee or dashboard injury Pain, effusion, positive draw tests Haemarthrosis Manage with rest + physio + consider reconstruction (more difficult with PCL)
26
Mechanism for meniscal tears
Adduction + internal rotation for lateral Twisting/blow to flexed knee for medial
27
Presentation of meniscal tears
Unable to walk, or only on tiptoe Knee 'locking'/'clicking' (limited extension) due to lodging of torn fragment OR knee giving way McMurray test +ve **IX: MRI to guide management**
28
Typical injury trid of the knee
ACL + medial collateral + medial meniscus
29
Differential diagnosis dep on timing of knee swellign
Immediate: fracture (haemarthrosis) Minutes-hours: ACL tear likely Within 24h: Synovial effusion, ACL tear less likely, possible meniscal tear
30
Epidemiology of tibial shaft fractures
Most common long bone fracture in adults Commonly young males Most commonly open fracture
31
Management of closed tibial shaft fractures
Assess fo compartment syndrome Interlocking intramedullary nailing
32
Presentation of patellofemoral pain syndrome
Young atheletes, often associated with increase in training load Patellar tracking/malalignment (ask for Hx of trauma or subluxation) **Symptoms:** Patella aching after prolonged sitting or stairs **Signs:** Medial retropatellar tenderness and tenderness on patellofemoral compression
33
Management of patellar tendinopathy or patellofemoral pain syndrome
Rest, physio +/- NSAIDs
34
Superficial bursitis presentation
Pain/swelling anterior to patella (can be prepatellar or infrapatellar bursa) and exacerbated by kneeling Common overuse injury
35
Knee bursitis management
Must not be aspirated so as not to seed infx! May be treated with topical NSAIDs or steroid injection
36
Pathophysiology of Baker's cysts
Primary: Herniation of joint synovium Secondary:Fluid buildup in semimembranosus bursa following chronic effusions in knee OA
37
Management of Baker's cyst
Rule out DVT/popliteal aneurysm Analgesia
38
Presentation of knee OA
Most common in black women, esp if \>55 and high BMI Knee pain on initiating movement, esp following inactivity (stairs, uneven ground) Varus deformity Crepitus + limited ROM
39
Management of knee OA
NSAIDs Weight loss Quadriceps exercises Osteotomy if young, active TKR (if night pain or significant life impact)
40
Signs of pelvic fracture
Leg length discrepancy Abdominal distension PV/urethral bleeding PR: haematoma, # line, rupture Loin bruising Perineal/scrotal haematoma
41
#NOF mortality
1 month: 10% 1 year: 30%
42
Management of pelvic fracture
External fixation with pelvic binder Consider IR embolisation
43
Insertions of ACL
Lateral condyle to intercondyloid eminence of tibia Anterior attachment on tibia
44
Insertions of PCL
Medial condyle of femur to posterior intercondyloid eminence of tibia Posterior attachment on tibia
45
Evaluation of hip screw placement
Tip-apex distance, determined under fluoroscopy
46
Risks of knee replacement
Bleeding Infection Fracture Soft tissue damage **NOT** dislocation
47
Late features of hip OA
Loss of ext rotation/abduction Limb shortening Fixed flexion/rotation
48
Management of acutely locked knee
Get MRI first! Do not force
49
Function of ACL
Prevents **FEMUR** subluxing posteriorly on tibia (or tibia anteriorly on femur)
50
Blood supply to femoral head
**Medial** circumflex artery Lateral lesser extent
51
Shapes of mensici
**Medial:** More crescent-shaped **Lateral:** More circular Blood supply from outside\>in --\> central avascular
52
Inspection of hip
360d view Increased lumbar lordosis - ?fixed flexion deformity 2ry to OA Walking aids and gait - esp antalgic, Trendelenburg (abductor weakness) Trendelenburg test (abductor weakness) Leg length discrepancy
53
Trendelenburg test
Standing on one leg, feel ASIS movement ASIS moves down = weak hip abductors **ON CONTRALATERAL SIDE**
54
Assessing leg length discrepancy
**True** - bony deformity e.g. due to fracture ASIS \> medial malleolus Assess w/ flexed knees to find where discrepancy is **Apparent** - joint deformity - e.g. fixed flexion due to OA/pain Xiphisternum\>medial malleolus
55
Modified Thomas' test
One hand under lumbar spine Both knees up to chest actively, then passive from examiner to compare flexion Extend normal hip then abnormal hip If abnormal hip not extending fully **OR** lumbar spine pressure reduced then test + ve Indicates fixed flexion deformity, note femur angle
56
Special tests hip
**FABER** - flexion, abduction, external rotation, press down on knee - indicates intra-articular pathology **FADIR** - flexion, adduction, internal rotation - indicates femoro-acetabular impingement **SLR** - for sciatica, reproduces pain
57
Causes of varus and valgus deformities
**Valgus** - usually RA **Varus:** - OA medial degeneration
58
Special tests knee
**Leg lag test** - Quad weakness **Anterior draw/Lachman's:** ACL **Posterior sag:** PCL **Collaterals:** Valgus/varus stress **Mensici:** Joint line tenderness, McMurray's

Orthopaedics and Trauma (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions