Low Limb Clinical Correlations

Question 1

Difference between incarcerated & strangulated hernia

Answer 1

Incarcerated: Painful enlargement of previous hernia & cannot be manipulated (symptoms: nausea, vomiting, bowel obstruction)
Strangulated: previous symptoms present but with a toxic appearance (strangulation probable if pain & tenderness of incarcerated hernia persist after reduction)

Question 2

4 types of femoral head fractures

Answer 2

I: Impaction of superior portion of femoral neck (incomplete fracture)
II: Nondisplaced fracture (complete fracture)
III: Partial displacement between femoral head & neck
IV: complete displacement between femoral head & neck

Question 3

What is Ortolani’s test used for?

Answer 3

Used to confirm diagnosis of congenital hip dislocation
More common in girls
60% of affected are firstborns

Question 4

Coxa vara

Answer 4

Angle of hip inclination is decreased
Mild shortening of lower limb caused
Limits abduction of the hip

Question 5

2 types of fractures to the femoral neck

Answer 5

Trans-cervical (middle of the neck)

Intertrochanteric

Question 6

Dislocated epiphysis of femoral head

Answer 6

Children - due to weakened epiphyseal plate
Or due to acute trauma/repeated microtraumas
Dislocated (slipped) epiphysis slowly results in coxa vara
Symptom: hip discomfort often referred to knee

Question 7

Spiral fracture of the femur

Answer 7

Results in foreshortening as fragments override

Union of this fracture may take up to 1 year

Question 8

Fracture of distal femur

Answer 8

Separation of the condyles

Results in misaligned articular surfaces of knee joint OR hemorrhage of popliteal artery (supplies blood to leg)