Musculoskeletal Flashcards
Structures in anterior compartment of leg
- Four extensor muscles of foot
- Anterior tibial artery
- Deep peroneal nerve
Most common site of acute compartment syndrome (p/w decreased sensation between 1st & 2nd toes + weakness with foot dorsiflexion)
Unstable C-spine fractures
Jefferson’s fracture, B cervical facet dislocation, odontoid fracture (type II or III), atlanto-occipital dissociation, Hangman’s fracture & flexion teardrop fracture
“Jefferson Bit Off a Hangman’s Thumb”
Biceps reflex nerve root
C5/6
Triceps reflex nerve root
C7
Brachioradialis nerve root
C6
Patellar reflex nerve root
L4
Achilles reflex nerve root
S1
Posterior hip dislocation complications
- Sciatic nerve injury: loss of sensation to posterior leg & foot; loss of dorsi-/plantar flexion; loss of ankle DTR
- Femoral nerve injury: Loss of sensation over thigh; weak quadriceps; loss of knee DTR
- Femoral artery injury
Stimson method
For shoulder dislocation; positions patient prone and utilizes hanging weight on affected arm to reduce dislocation
Radiographic findings of slipped capital femoral epiphysis
widening of the physis –> displacement of femoral head from femoral neck (“ice cream off cone”)
What is a Galeazzi fracture and what are the complications
- fracture to middle to distal 3rd of radius & dislocation/subluxation of distal radioulnar joint (DRUJ)
- anterior interosseus nerve (branch of median nerve) injury: paralysis of flexor pollicis longus & flexor digitorum profundus (loss of punch mechanism between thumb & index finger, AKA “OK” sign)
What is a Monteggia fracture
Fracture to proximal/mid-ulna with radial head dislocation
Describe perilunate dislocation
Dorsal dislocation of capitate and carpus relative to lunate, which remains in near-normal alignment with the radius
Describe lunate dislocation
Radiolunate articulate disrupted with volar displacement of lunate (“spilled teacup sign”)
Common feared complication of perilunate dislocation?
Median nerve palsy
Mallet finger deformity pathophysiology, management & complication
- path: forced hyperflexion of distal phalanx –> disruption of extensor tendon at DIP –> unopposed flexion at DIP
- Mgmt: splint in slight hyperextension for 6-8 weeks
- comp: swan neck deformity
Boutonniere deformity pathophysiology & management
- path: rupture of central slip over PIP joint (typically from jammed finger) –> volar migration of lateral bands –> PIP joint in flexion + DIP in hyperextension
- mgmt: splint PIP joint in full extension for 6 weeks
Gamekeeper’s (skier’s) thumb pathophysiology, exam & management
- path: rupture of ulnar collateral ligament (2/2 forced abduction)
- exam: weak pincher grasp
- mgmt: thumb spica splint for 4-6 weeks
S1 radiculopathy presentation
- Pain down posterior leg into foot
- Paresthesia on posterior aspect of leg & anterior aspect of foot
- Weak ankle plantarflexion (gastrocnemius), knee extension & flexion
L3 radiculopathy presentation
- Weak hip flexion & adduction
- Paresthesias to anterior thigh
L4 radiculopathy presentation
- Weak knee extension
- Paresthesias of lateral thigh, anterior knee & medial leg
L5 radiculopathy presentation
- back pain radiating down lateral leg
- weak dorsiflexion & great toe extension
- hypoesthesia to lateral lower leg, dorsum of foot & webspace between 1st & 2nd toes
(most common lumbar radiculopathy)
Scapholunate dissociation mechanism, pathophysiology, imaging & management
- mech: FOOSH
- path: rupture of scapholunate ligament
- img: widening of scapholunate joint space >3 mm (Terry-Thomas sign)
- mgmt: forearm volar splint
Jones fracture pathophysiology & management
- path: transverse fracture through base of 5th metatarsal (diaphysis at least 1.5 cm distal to end of bone)
- mgmt: immobilization in posterior splint, non-weight bearing
Pseudo-jones fracture pathophysiology & management
- path: avulsion fracture of tuberosity of base of 5th metatarsal (reaches articular surface)
- mgmt: compression dressing & weight bearing as tolerated (+/- hard-soled shoe)
