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2 - LOCO/HSPH/CANCER > Loco orthopaedics > Flashcards

Loco orthopaedics Flashcards

1
Q

Most common fracture

A 
<75 = Colles 
>74 = hip
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2
Q

Comminuted fracture

A

2 or more bone pieces

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3
Q

Places where avulsion fractures can occur

A

Ischial tuberosity = hamstring
Medial epicondyle = flexors and pronators
ASIS = sartorius
AIIS = rectus femoris

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4
Q

Where are bust fractures most common?

A

Thoraco-lumbar junction

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5
Q

Types of stress fracture

A 
Fatigue = abnormal stress on normal bone 
Insufficiency = normal stress on abnormal bone
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6
Q

Stage 1 of bone healing

A

Fracture haematoma
Blood clot forms
low pH and hypoxia
Recruitment of inflammatory cells

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7
Q

Stage 2 of bone healing

A 
Soft callus 
New capillaries remodel haematoma 
Inflammatory cells remove dead bone 
Fibroblasts and chondrocytes begin to produce fibrous tissue = soft callus 
Osteoblasts begin to enter area
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8
Q

Stage 3 of bone healing

A

Hard callus

Osteoblasts produce woven bone to replace soft callus

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9
Q

Stage 4 of bone healing

A

Remodelling

Woven bone is remodelled into lamellar bone

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10
Q

Blood loss from fractures

A 
Tib/fib = 500ml 
Femur = 500ml 
Pelvic = 2000ml
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11
Q

Nerve injuries as a result of trauma

A 
Neurapraxia = nerve compression without axonal disruption 
Axonotmesis = axoplasmic disruption but endoneurial sheath intact 
Neurotmesis = axon and axon sheath disrupted
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12
Q

Absolute indications for ORIF

A 
Displaced intra-articular fractures 
Open fractures 
Fractures with vascular injury or compartment syndrome 
Pathological fractures 
Non-union
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13
Q

Relative indications for ORIF

A

Loss of position with closed reduction
Poor functional result
Displaced fracture with poor blood supply

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14
Q

Radiological union

A

When 3 out of 4 cortices are healed

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15
Q

Signs of fat embolus

A

Hypoxaemia
Petechial rash
Neurological signs –> snowstorm appearance on MRI

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16
Q

Compartment syndrome pressures

A

Normal = 0-10mmHg
Capillary blood flow compromised = >20mmHg
Nerve and muscle fibre damage = >30-40mmHg

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17
Q

Hybrid and reverse hybrid hip replacement

A

Hybrid = cemented stem and cement less cup

Reverse hybrid = cementless stem and cemented cup

18
Q

Characteristics of body part used for tendon transfer

A

Under voluntary control
Expendable
Adequate tendon length
Be innervated to a different nerve to the one that was damaged

19
Q

When is tendon transfer done?

A

Nerve palsy

20
Q

What muscle imbalances occur in cerebral palsy?

A

Quadriceps > hamstrings

Plantarflexors > dorsiflexors

21
Q

What can be used for ACL reconstruction?

A 
Patella-ligament-tibia 
Hamsting tendon (semitendinosis, gracilis)
22
Q

Define delayed healing

A

Failure in 1.5x normal time

23
Q

Define non-union

A

Failure in 2x normal time

24
Q

Sites of autograft harvesting

A

Iliac crests
Ribs
Fibula
Mandible

25
Q

Properties of bone grafts

A 
Osteoconduction = scaffold for cells 
Osteoinduction = molecules in graft induce neighbouring cells to become osteoblasts 
Osteopromotion = graft material enhances osteoinduction (but does not induce osteoblast differentiation itself) 
Osteogenesis = cells in the graft are capable of producing bone
26
Q

What pathologies can cause toe walking?

A

Cerebral palsy
Duchenne muscular dystrophy
Nervous system problems

27
Q

Risk factors for talipes equinovarus

A

Breech presentation
CT disorders
Poly/oligohydramnios
Family history

28
Q

Treatment of talipes equnovarus

A

Ponseti method

29
Q

Risk factors for CHD

A

Breech delivery

First born child

30
Q

Presentation of CHD

A

Asymmetrical leg length
Uneven thigh and gluteal folds
Leg turned into external rotation
Limited abduction

31
Q

Diagnosis of CHD

A 
Barlow = adduction 
Ortolani = abduction 
Galeazzi = leg length
32
Q

What should normal alpha angle be on ultrasound

A

> 60

33
Q

Hilgenreiner’s line

A

Between inferior aspects of triradiate cartilages

34
Q

Acetabular angle

A

<30 degrees

Gets smaller with age

35
Q

CHD treatment

A

Pavlik harness
Hip spica
Closed reduction
Corrective osteotomy

36
Q

Stages of Perthes disease

A

Necrosis
Fragmentation
Re-ossification
Remodelling

37
Q

SUFE presentation

A

Limited internal rotation

38
Q

Risk factors for SUFE

A

Obesity
Hypothyroidism
Early or late puberty

39
Q

Klein’s line

A

Along superior border of femoral neck

Should intersect femoral head

40
Q

Blount’s disease

A

Medial tibia growth problem

Leads to varus deformity

41
Q

Kohler’s disease

A

Osteochondrosis disorder affecting the foot joints

2 - LOCO/HSPH/CANCER (9 decks)

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