Ian Mayne 1 Flashcards
List the mechanism of action of Nitrogen containing bisphosphonates and provide an example:
- Inhibits osteoclast farnesyl pyrophosphate synthase enzyme
Example - alendronate
- risedronate
- pamidronate
- zolendronate
List 8 Dystrophic Scoliosis Changes associated with Neurofibromatosis Type 1:
- Vertebral scalloping (depth >3 mm in the thoracic spine or >4 mm in the lumbar spine). This is associated with
either dural ectasia or neural tumor. - Rib penciling (present when the width of the rib is smaller than that of the narrowest portion of the second rib)
- Transverse process spindling
- Vertebral wedging
- Short curve with severe apical rotation
- Intervertebral foraminal enlargement
- Widened inter-pedicular distances
- Dysplastic pedicles
List the return of nerve function after injury from earliest to latest:
- Sympathetic
- Pain
- Temperature
- Touch
- Proprioception
- Motor
What surgical procedure is used to correct a 1st MT claw toe deformity in Charcot-Marie-Tooth patients?
Modified Jones Procedure
(eliminate overactive EHL and correct claw toe deformity)
* Perform EHL tenotomy as distal as possible and tag
* IP arthrodesis: deformity correction of IP joint and fusion
* EHL tendon transfer through bone tunnel in distal 1st MT (head-neck jxn)
List two absolute indications for an emergent Thoracotomy:
- Chest Tube drains >1500cc immediately after insertion
- Chest tube output >200cc/hr for 3 hours
List 5 “Tetanus Prone” wounds:
- Devitalized tissue
- > 6 hr
- Burns, frostbite
- Soil, manure
- Puncture wound
- Signs of sepsis
List 5 indications for a Shoulder Arthrodesis:
- Failed revision shoulder arthroplasty
- Anterior poliomyelitis
- Brachial plexus injury (upper cervical)
- Axillary Nerve Paralysis
- Recon after tumour resection
- Failed Shoulder stabilization procedures (Ex/ Multidirectional Instability)
The patient retains approx. 1/3 of normal shoulder motion after arthrodesis à Scapulothoracic motion
List 4 important technical steps in a Tibial Tubercle Osteotomy for increased exposure during TKA:
Skin exposure: *must be extended inferiorly for 8-9 cm so that the patellar tendon insertion can be completely
visualized.
Osteotomy: extends from the top of the tubercle to 6 to 8 cm distally. Approximately 2 cm wide and of variable
depth, (8-10mm proximally to 5-7mm distally
Lateral soft tissue hinge is left intact to preserve its blood supply
Fixation: screws or wires**
List 3 contra-indications to a Knee Arthrodesis:
- Ipsilateral Hip OA
- Contralateral knee OA
- Debilitating back pain
- Infection
Describe the ideal position of a knee fusion:
- 7° ± 5° valgus
- 15° ± 5° flexion
- Differentiate between Dystrophy vs Myopathy
Dystrophy:
* progressive deterioration of muscle
* Any boy who is not walking by 18 month should be screened for Duchenne’s Musc Dystrophy with a serum CK
level (5,000-15,000u/L)
Myopathy:
* abnormality of muscle that may impair function but is not progressive
- What is the definition of a true AP of the pelvis?
x-ray centered over the symphysis pubis and aligned with the coccyx
- What is the most reliable radiographic method of determining whether one should opt for Proximal humerus ORIF or
hemi-arthroplasty?
Combined cortical thickness is the average of the medial and lateral cortical thickness at the two levels
* Cortical thickness <4 mm: Nonsurgical treatment or hemiarthroplasty
* Cortical thickness ≥4mm: ORIF
List the steps in a Rapid Sequence Intubation:
- Pre-oxygenate with 100% O2
- Apply cricoid pressure
- Succinylcholine 1-2mg/kg IV
- Insert ETT, inflate cuff
- Confirm placement with ETCO2
- Release cricoid pressure
List the 5 stages of the Wagner Classification for Diabetic Foot Ulcers:
- 0 - Intact Skin
- 1 - Superficial ulcer of skin or subcutaneous tissue
- 2 - Ulcers extend into tendon, bone, or capsule
- 3 - Deep ulcer with osteomyelitis, or abscess
- 4 - Gangrene of toes or forefoot
- 5 - Midfoot or hindfoot gangrene
