lower extremity orthopaedics Flashcards
1
Q
classify physis (growth plate) fracture
A
- salter-harris
- I: Seperate
- II: Above
- III: Lower
- IV: Through
- V: Reduced
2
Q
what type of fx is this
A
- Torus or “buckle” fracture
- unique to children
- looks like compacted soda can
3
Q
what type of fracture is this
A
- greenstick fracture
- fracture of the bone, occurring typically in children, in which one side of the bone is broken and the other only bent.
4
Q
what type of fracture is this
A
oblique fx
5
Q
describe fracture
A
- transverse and bayoneted fx
6
Q
describe fracture
A
comminuted fx
7
Q
CRPPF surgery
A
closed reduction percutaneous pin fixation
8
Q
ORIF surgery
A
- open reduction internal fixation
9
Q
50% of pelvic fractures are associated with
A
- internal injuries
- vascular hemorrhage
- intraabdominal, bladder, aortic injuries
10
Q
gold standard for diagnosing pelvic fracture
A
- CT scan
11
Q
most common type of pelvic fracture
A
- posterior wall fx with possible associated femoral head dislocation
- avulsion fx in skeletally immature athletes
12
Q
most hip dislocations are ? How will the patient present
A
- posterior dislocations
- adduction and internal rotation of affected leg
13
Q
how do anterior dislocations present
A
- slight abduction and external rotation
14
Q
complications of hip dislocation
A
- sciatic nerve damage
- avascular necrosis
- arthritis
15
Q
clinical presentation
- pain to groin and radiates to inner thigh
- difficulty with flexion and internal rotation
- will hold leg in external rotation/abduction
- leg may appear shorter
A
hip fracture
16
Q
imaging if you suspect hip fracture
A
- plain radiographs: AP/lateral
- CT
- MRI if high suspicion and neg xrays
17
Q
describe intracapsular hip fracture. adverse effect of this injury
A
- neck/head of femur within capsule
- avascular necrosis
18
Q
describe an intertrochanteric hip fracture
A
- between neck and lesser trochanter
19
Q
describe subtrochanteric fracture
A
- below lesser trochanter
20
Q
important to give patient this medication for hip fracture
A
- prophylaxis for DVT
21
Q
septic hip and transient synovitis peak presentation
A
- neonates
- 3-6 y.o
22
Q
transient synovitis is often caused by a viral infection and often associated with a
A
- recent illness
23
Q
leg position typical of septic hip
A
- hip flexed, externally rotated and abducted
24
Q
criteria to differentiate transient synovitis and septic hip
A
-
Kocher criteria
- WBC > 12,00
- ESR > 40
- Fever > 101.3
- non weight bearing on affected side
- 2/4 warrants joint aspiration
25
what image modality is preferred if diagnosis of septic hip is questionable or surgery is scheduled
MRI
26
another way to help differentiate between septic hip and transient synovitis is the administration of this medication
* **NSAIDS**
* ****transient synovitis will improve with NSAIDS
27
how is septic hip diagnosed
* joint aspiration
28
describe slipped capital femoral epiphysis (SCFE)
* slippage of femoral epiphysis on the femal metaphysis
* ice cream falling off cone
29
typical patient population associated with slipped capital femoral epiphysis (SCFE)
* obese, adolescent males
* african american
30
clinical presentation
* pain: hip, thigh, knee
* limp or NWB
* abduction and internal rotation
slipped capital femoral epiphysis (SCFE)
31
management of slipped capital femoral epiphysis (SCFE)
* emergent surgery
32
typical patellar dislocation location
* **lateral** dislocation
* MOI: twisting on flexed knee
33
imaging for patellar dislocation
* not necessary prior to reduction
* immediate reduction required
34
largest sesamoid bone
* patella
* improved knee extension
35
clinical presentation
* direct force in knee flexion
* knee effusion
* **inability to extend knee**
patellar fracture
36
managment of patellar fracture
* splint in full extension
* NWB
* eventual PT
* surgery for complex or displaced fx
37
what concomitant injuries are likely with tibial plateau fracture
* meniscus
* ligament injury
38
radiograph views for tibial plateau fracture
* AP
* lateral
* intercondylar notch view
39
treatment of tibial plateau fracture
* splint in full extension
* NWB
* ortho consult
40
most common cause of proximal tibia fracture in children
trampoline
41
complication of proximal tibia fracture
* post-traumatic bowing
42
tibial shaft fractures have a high risk for
* anterior compartment syndrome
43
what is a toddlers fracture
* pediatric tibia shaft fx
* common cause: child falling while running often with twisting mechanism
44
how is toddlers fracture diagnosed and treated
* often clinical diagnoses
* tx: cast
45
triplane fracture
* seen in adolescents
* a vertical fracture through the epiphysis
* a horizontal fracture through the physis
* an oblique fracture through the metaphysis
46
MOA for 5th metatarsal fx
* inverson
47
describe avulsion fx of 5th metatarsal
* peroneus brevis inserts on base of 5th MT
* avulsion along lateral tuberosity
48
describe jones fracture
* base of 5th metatarsal at the **metaphyseal/diaphyseal junction**
49
stress fractures are most common in what metatarsal
* 3rd MT
50
tx of jones fx
* surgery due to slow healing
51
tx of stress fx and avulsion metatarsal fx
* conservative tx
* cast vs CAM boot
52
what is a Lisfranc fracture
* fx of 1st and 2nd tarsal metatarsal
* MOI: step off curb or into hold, fall from high height
53
imaging if you suspect a Lisfranc fracture
* AP WB BL feet
* lateral radiographs
* early recognition important
54
achilles tendon is common insertion site for
* gastrocnemius/soleus
55
test for achilles tendon rupture
* thompson test
