MSK Flashcards

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1
Q

What is the most common type of shoulder dislocation?

A

Anterior

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2
Q

Initial management of shoulder dislocation

A

Analgesia and support in temporary sling

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3
Q

Give the names of 3 shoulder relocation methods

A

External rotation, kocher, milch

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4
Q

What should be done if shoulder has been dislocated for >24 hours?

A

Reduce under GA

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5
Q

What investigations/ management are needed after shoulder reduction?

A

Recheck pulses and sensation
Xray
Immobilise in collar and cuff
Analgesia and follow-up

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6
Q

Which nerve can be damaged in shoulder dislocation?

How may this present?

A

Axillary nerve

Reduced sesation in ‘regimental badge’ area

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7
Q

What can cause posterior shoulder dislocation?

A

Anterior blow
Fall onto internally rotated arm
Seizure
Electric shock

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8
Q

Difference in presentation between anterior and posterior shoulder dislocation

A

Anterior: arm is externally rotated and abducted

Posterior: arm is internally rotated

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9
Q

What is the most common mechanism of ankle sprain?

A

Inversion injury

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10
Q

Which ligament is most commonly damaged in ankle sprain?

A

Anterior talofibular

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11
Q

In suspected ankle sprain, where do you feel for tenderness over? (6)

A
Proximal fibular
Lat and med malleoli
Navicular
Calcaneum
Achilles
Base of 5th MT
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12
Q

Ottawa criteria: what question does this help answer?

A

Is an xray required for this ankle?

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13
Q

Describe the Ottawa criteria

A

BONY TENDERNESS over 6cm above malleolus/ base of 5th MT

UNABLE TO WEIGHT-BEAR for 4 steps at the time of injury and examination

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14
Q

What advice would you give to someone with a sprained ankle?

A

RICE!

Initial rest: ankle above hip level, intermittent ice for 10 mins

Begin to weight bear asap!!

Gentle exercise

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15
Q

Someone with a sprained ankle wants to use an elastic support, what do you need to tell them?

A

Do not wear it in bed

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16
Q

How long should it take for a minor sprain to recover?

A

Around 4 weeks

17
Q

Give 2 complications of ankle sprain (re peroneal)

A

Peroneal tendon subluxation: sensation of clicking/ snapping - may require surgery

Peroneal nerve injury

18
Q

In peroneal nerve injury, where is sensation reduced?

A

Reduced sensation over the dorsum

19
Q

Why is there an increased risk of hip fracture in the elderly?

A

Osteoporosis
Osteomalacia
Inc falls risk

20
Q

How may the leg appear in #NOF

A

Leg looks shorter and is EXTERNALLY rotated

21
Q

An elderly patient with dementia presents with sudden inability to WB - should you suspect #NOF?

A

YES!!! they may not remember the fall itself

22
Q

Where may pain in #NOF radiate?

Considering this, when should you suspect #NOF?

A

May radiate to the knee

Suspect #NOF if unable to WB and pain in the knee

23
Q

What is the name of the lines you look for in a hip xray?

A

Shenton’s lines - compare the shape on both sides

24
Q

How many classes of hip # are there?

A

4 (garden 1234)

25
Q

Describe grades 1 and 4 of #NOF

A

1: trabecular angulated, no significant displacement

Grade 4: gross, complete displacement of the femoral head

26
Q

What are the principles of #NOF management?

A
IV access
Fluids if dehydrated/ shock
Analgesia and anti-emetic
Try to determine the cause: CXR, ECG etc
Admit to orthopaedics
27
Q

Colle’s fracture

  • location
  • mechanism
  • appearance
A

Within 2.5cm of the wrist

FOOSH

‘dinner fork appearance’

28
Q

In Colle’s #, how may the radius appear on xray

A

Posterior and radial displacement of the distal fragment of the radius

29
Q

What is the management of a simple colle’s #?

A

Analgesia
Immobilise in backslab POP
Elevate with sling
Follow-up with # clinic

30
Q

When is manipulation under anaesthesia required in distal radius #?

A

Grossly displaced #

Loss of normal forward radial articular surface tilt on xray

31
Q

What is a Smith’s fracture?

A

Usually caused by falling onto flexed wrists (RARE)

Distal radius displaced anteriorly