LE Ortho

Question 1

hip dislocation presentation (2)

Answer 1

posterior: adduction & internally rotated
anterior: slight abduction & external rotation

Question 2

hip fx presentation (2)

Answer 2

pain to groin, radiating to inner thigh

leg held in external rotation/abduction

Question 3

neck/head of femur within capsule

concerns for loss of blood supply, avascular necrosis

Answer 3

intracapsular hip fx

Question 4

fx b/w neck & lesser trochanter of femur

Answer 4

intertrochanteric

Question 5

subtrochanteric fx

Answer 5

below lesser trochanter of femur

Question 6

Kocher criteria (4)

Answer 6

WBC 12,000+
ESR 40+
fever 101.3+
NWB on affected side

Question 7

SCFE ROM restriction

Answer 7

abduction & internal rotation

Question 8

SCFE with radiographic evidence of slip and less than 3 weeks symptoms

Answer 8

acute

Question 9

acute-on-chronic SCFE

Answer 9

pain more than 3 weeks

effusion and metaphyseal remodeling seen on imaging

Question 10

imaging finding for chronic SCFE

Answer 10

metaphyseal remodeling but no effusion

Question 11

tibial plateau MOI (3) & associated injuries (2)

Answer 11

falls, contact sports, motorcycle injury

a/w meniscus, ligament injury

Question 12

tibial plateau fx treatment

Answer 12

splint in full extension, NWB up to 6 weeks

Question 13

proximal tibia fx common MOI & tx

Answer 13

trampolines

long leg cast

Question 14

tibial shaft fx MOI

and caution

Answer 14

twisting of the leg with the foot planted, direct impact, fall

avoid tight Ace bandages or early casting due to swelling- high risk for anterior compartment syndrome

Question 15

tibial shaft fx tx (2)

Answer 15

NWB

long leg splint

Question 16

pediatric tibial shaft fx MOI, presentation, and treatment

Answer 16

child falling while running, often with twisting mechanism

pt won’t walk on foot, may look like foot pain

casting- splint anyways, refer even if you don’t see it on X-rays

Question 17

a/w with lateral malleolus fx?

Answer 17

lateral ligament complex sprain

Question 18

ankle fx tx

Answer 18

splinting, brace, CAM boot

RICE, NWB

Question 19

metatarsal stress fx is most common in?

Answer 19

3rd MT due to repetitive activity

Question 20

5th MT avulsion due to? (2)

and treatment? (3)

Answer 20

inversion, high heels

cast/CAM boot
restricted WB
activity modification

Question 21

Jones fx

and treatment?

Answer 21

base of the 5th MT at the metaphyseal/diaphyseal junction

requires surgery due to slow healing

Question 22

Lisfranc fx
& MOI
presentation

Answer 22

fracture or dislocation of 1st and 2nd TMT

stepping off curb or into hole, MVA, fall

mid foot pain

Question 23

Lisfranc fx imaging & treatment (2)

Answer 23

AP bilateral WB feet, lateral X-rays

needs stabilization early! casting
surgery if > 2 mm

Question 24

Calcaneal fx imaging & tx

Answer 24

lateral view most helpful

casting w/ NWB
surgery only if displacement

Question 25

positive Thompson test?

Answer 25

intact achilles tendon

squeeze calf –> plantarflexion

Question 26

Achilles tendon tear tx

Answer 26

splint/boot in plantar flexion, usually can treat conservatively

Question 27

most common pattern of pelvic fx

Answer 27

posterior wall fx w/ possible assoc. femoral head dislocation