hip and LE Flashcards
hip fx
presentation
associated with what
tx
shortened and ER leg
displaced femoral neck fx assoc with risk of AVN and nonunion
also increased risk of OP and DVT
ORIF, maybe hemi or total
*anticoagulate
legg calve perthes disease
avascular necrosis of femoral head. occurs in ages 2-11 with peak b/t 4-8 yrs
persistant pain, limp, LROM, limited IR and abduction
kid presently with persistant hip pain, loss of motion…particularly IR and abduction
legg calve perthes disease
avascular necrosis diagnostic study and tx
MRI. protected wt bearing in early disease. alendronate. no bracing
what is slipped capital femoral epiphysis and age of occurence
weakening of the epiphysiseal plate of femur then displacement of femoral head. occurs in ages 10-16 years of age.
what to consider if slipped capital femoral epiphysis occurs in younger kids
hypothyroidism and hypopituitarism
best way to dx slipped capital femoral epiphysis
hip frog xrays
lateral pelvis show posterior medial displacement
slipped capital femoral epiphysis tx
pining in situ, crutches, NWB
what is thompson’s test
done to r/o achilles tendon rupture
what is the most common deformity of the MTP joint
hallus valgus(bunion)
mortons neuroma characteristics
caused from irritation of interdigital nn rubbing on transverse ligament. occurs in 3rd web space, more common in women
mortons neuroma sx
pain and localized numbness with walking/standing, relieved with rest. PE is squeeze forefoot
plantar fascitis location, sx, PE, dx, and tx
calcaneal.pain 1st few steps in am and heel pain at night.
PE shows pain at calcaneus and inflexible achilles tendon. xray shows spur or fx.
MRI shows calcifications.
tx 6-12 months PT,stretch, inj?; surgery for extreme cases
cause of AVN hip
unknown
describe AVN hip
loss of blood supply to trabecular bone-collapse of head
loss of ER, IR, abduction
pain relieved by rest
AVN hip
imaging
tx
MRI
crescent sign in late lateral film
bone scan
alendronate, sx decompression, total
no brace in kids-just protected WB
what 2 hip disorders are bilateral
AVN and slipped capital femoral epiphysis
slipped capital femoral epiphysis presentation
insidious hip/thigh, knee pain, painful limp
fat emboli
fever, mental status change, dyspnea, hypoxia, petechia, decreased platelets
watch for compartment syndrome
ankle sprain/strain
85% what kind
what ligaments
tx
inversion
lateral ligaments
PT 3-4 months, RICE, crutches
achilles tendonitis exam
tender post calf above calcaneous
passive dorsiflexion with resisted plantar flexion
nml ankle ROM and strength
avoid injection in what
achilles tendonitis
achilles rupture exam
tx
limited plantar flexion
+ thompson test
surgery then cast 6 weeks
thompson test
pressure on gastroc leading to absent foot plantar flexion
achilles rupture
bunion
MTP, lateral deviation
morton neuroma
traction of interdigital nerve against ___ ___ ligament causing degeneration of nerve and chronic inflammation
affects __ web space
pain with ___ and ___
relieved by ___
transverse metatarsel
3rd
walking and standing
rest
morton neuroma
imaging
tx
nml xrays
MRI SENSITIVE but not needed
surgery but will be numb
