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A - Rosen Ortho > LE, Joint Infections > Flashcards

LE, Joint Infections Flashcards

1
Q

MC bacteria in human bites?

MC in fresh water?

A

Strep anginosus, Fusobacterium nucleatum, Eikenella

Aeromonas hydrophila

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2
Q

How do you know antibiotic treatment is working for osteomyelitis?

A

Abx dosed to serum level 8x greater than minimum inhibitory [ ]

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3
Q

What Abx have the best cure rates for osteomyelitis?

A

Oxacillin/nafcillin better than vancomycin

Can add Cipro/levofloxacin or 3rd gen cephalosporin

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4
Q

What is the Kocher criteria used for?

if 2 are met, what is chance?
3?

A

ID children w/septic arthritis of the hip

40%
93%

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5
Q

What are the 4 Kocher criteria?

A

Fever > 101F
Non weight bearing on side
ESR > 40
WBC > 12,000

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6
Q

What are the hard signs of vascular knee injury in a knee dislocation (tibiofemoral disruption)?

A

Absent pedal pulse
Cool, mottled foot
Expanding popliteal hematoma
Popliteal hemorrhage

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7
Q

How to treat knee dislocation that has normal ABI with no soft sign of vascular injury?

A

Posterior splint in 15 degrees flexion

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8
Q

What fracture represents a bone avulsion of the lateral tibial plateau?

Accompanied by what?

MC MOA?

A

Segond fracture (looks curvilinear)

ACL disruption/injury

Sports - knee flexion w/IR and Varus stress

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9
Q

Management of tibial plateau fracture in the ED?

A

Knee immobilization in non-circumferential splint, non-weight bearing
Ortho in ED or f/u

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10
Q

All fractures of the patella are considered what?

MC type?

A

Intra-articular

Transverse

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11
Q

What are the 4 compartments in the leg?

A

Anterior
Lateral
Superficial posterior
Deep posterior

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12
Q

What fracture is described by deltoid ligament tear/medial Malleolus fracture w/complete tearing of syndesmotic ligament of tib/fib and fracture of the proximal fibula?

Treat how? Why?

A

Maisonneuve fracture

ORIF, unstable ankle mortise

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13
Q

What is a Baker’s cyst?

What causes it?

A

Popliteal cyst that is a herniation of the synovial membrane through the posterior aspect of the knee capsule

Results from an enlarging knee effusion of any cause

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14
Q

What ankle fracture characteristic requires Ortho eval urgently (can be outpatient)?

A

Any abnormal measurement on ankle mortise view

  1. Talocrural angle 83 +/- 4
  2. Medial clear space >/= 4mm
  3. Talar tilt = 2mm
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15
Q

What kind of isolated lateral malleolar fracture requires ortho in the ED?

A

Danis-Weber type C —> fibular fracture proximal to tibiotalar joint line

Type B (at level of joint line) may consult Ortho also

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16
Q

What is a pilot fracture?

Occurs how?

Manage how?

A

Fracture of the distal metaphysis of the tibia

Fall from height, caused by axial compression

Requires ORIF, need ED ortho consult

17
Q

What joint connects the midfoot to the Forefoot?

A

tarsometatarsal joint aka Lisfranc joint

18
Q

What joint connects the hind foot to the midfoot?

A

Midtarsal aka Chopart’s joint

19
Q

How many grades of Talar neck fractures? What system?

Significance of these?

A

4, Hawkins

Neck fox make up 50% of major talar fractures

20
Q

What measurement to look for Calcaneal displacement/fracture?

A

Boehler’s angle (20-40 degrees)

21
Q

What is a possible major complication in Lisfranc injury? Why?

A

vascular injury —> branch of dorsalis pedis artery dives bw 1st and 2nd metatarsal to form plantar arch

22
Q

What is a nutcracker foot injury?

A

Occurs to the cuboid bone being wedged bw calcaneus and 4th and 5th metatarsal bases

23
Q

Where does a Jones fracture occur?

A

Base of 5th metatarsal through the 4th and 5th intermetatarsal articulation

24
Q

How many compartments in the foot?

When does compartment syndrome usually occur?

A

4 - medial, central, lateral, interosseous

15-30 hours but can occur as early as 2-6 hours

25
Q

Lateral radiographs of the ankle may show what in Achilles’ tendon rupture?

A

Opacification of the triangular fatty-tissue space anterior to the tendon called Kager’s triangle

26
Q

What are the Ottawa Foot Rules?

A

Tenderness over navicular
Tenderness at base of 5th metatarsal
Inability to bear weight for 4 steps after injury

27
Q

What is the classification system called for Supracondylar fractures?

What grade requires Ortho for immediate surgery? Describe it

A

Gartland

III —> displaced with the cortex having no contact

A - Rosen Ortho (3 decks)

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