OITE2015 Flashcards
Most common type of neonatal brachial plexus palsy?
Upper Trunk injury ( ERB)
Klumpke- Lower roots
Effective Tx with Flex Contracture >40d with brachial plexus injury?
Serial Casting
AP axis of limb differentiation controlled by?
Zone of Polarizing activity. This Zone is in posterior aspect of Apical Ectodermal Ridge. Sonic hedgehog is produced here too
Fibrillin 2 defect?
Congenital contractual arachnodactyly
Defect in Collagen Type III
Ehlers-Danlos
Femoral Palsy 2/2 Pavlik treatment?
DC pavlick, watch for return to FXN. Compressed under inguinal ligament
Infantile BLounts Initial treatment? (MD angle >16d)
At age 2–> Orthosis
Osteotomy–>before age 4
Percentage of proximal humeral growth plate to overall length of humerus?
80%
Kohlers Disease?
AVN os navicular–> Tx with immobilization
Morquio Syndrome additional testing?
C1/2 instability–> needs Cspine films before surgery. Is Muccopolysaccharidosis
Juvenile Arthritis
- 4 or fewer joints
- Symmetrical hands/wrist ankles
- chronic eye inflammation
INjury most associated with scapular fractures?
Lung contusion–> get chest CT
Malunion associated with IMN of proximal tibial shaft fractures?
Procurvatum and VALGUS
AP width of proximal tibia is more narrow____ than___
Medial than lateral–> forces nail laterally (valgus) with medial starting point
Total Elbow Replacement approach?
You CANT do posterior/olecranon approach. NEED to do posterior/Triceps splitting
Double arch sign on lateral elbow?
Capitellar shear fracture–>Lateral column extensile approach
Humeral Shaft Osteosynthesis Vs IMN
IMN: increaed malreduction, malrotaiton, shoulder stiffness . NO difference union rate, EBL
Medial Epicondyle View on plain films
Medial distal humeral Axial View
Approximate Elastic Modulus of Titanium?
100MPa (cortical bone 15- stil closest
Hip Fracture elderly In hospital Mort/1 year Mort`
6%, 30%
Electric stimulation mechanism ?
Promotes upregulation of growth factors
Bare Area (ulna lacks articular cartilage)?
Dorsal cortex 2cm distal to triceps insertion
CLASS I Hemorrhage:
NL BP
HR<100
750mL or less
CLASS II Hemorrhage:
NL BP
HR >100
Decreased PP
750-1500
CLASS III Hemmorrage
Decreased BP
HR>120 Decrased PP
1500-2000ML EBL
CLASS IV
Lethargic
HR>140
Decrased BP
Hypotensive
Vancouver A
ORIF if displaced (Fater in trochanteric region)
Vancouver B1 Tx:
B1: around stem, WELL FIXED
TX: ORIF cables, plates
Vancouver B2 Tx:
Around stem, LOOSE, GOOD proximal bone
TX: REvision Femoral component- 2 canal diamters past
Vancouver B3 Tx:
Poor quality proximal bone- Proximal femoral replacement
Vancouver C:
Below prosthesis, Treatment ORIF with plate
Mirror Therapy?
PHantom limb pain
2mm of shortening of Metacarpal fractures ___mm of extensor lag?
7 mm
Camptodactyly?
flexion contractures: surgery often dissapointing. Passive stretching is younger than 3 yo
Brachial Plexus injury VS root avulation?
Dorsal scapular nerve is uslaly sparred in root avulsion (Rhomboid)
Long term sequela from hook of hamate fracture?
Small finger FDP rupture
Scaphoid ORIF
- Displaced 1mm or greater
- Intrascaphoid angulation > 45d
Approach for proximal pole scapohoid Fx/
Dorsal
Thumb CMC restraint to DORSAL dislocation?
Dorsal Radial Ligament
What is FCR is missing for suspension arthroplasty for CMC arthritis?
Use the ECRL
Safe Zone for acetabular placemnt
30-50ABD
5-25 anteversion
Fatigue Cracks asscoaited with?
Fretting corrosion (titanium)
Kerboul Angle and percent collapse at 5 years?
<190- 0%
190-240- 50%
100% >240
Estimated EBL for isolated femoral shaft fracture?
1250cc(1276)
Patellar Clunk Risk Factors?
- Posterior stabilized knee
- Smaller patellar components
Lateral Stability in Extension of knee?
Lateral stability in flexion of knee?
- IT band
- Popliteus
Risk Factor for Posterior dislocation?
- Spinal disease
- Alcoholism
- Failed capusuar repair
- Neuromuscular disease
Most common revision resion <2years?
>2 years?
- Infection <2 years
- Aseptic Loosening >2 years
Pelvic Incidence=?
SS+PT
Pelvic Incidence will NOT change
Dial Test
> 10° external rotation asymmetry at 30° only consistent with isolated PLC injury
10° external rotation asymmetry at 30° & 90° consistent with PLC and PCL injury
MOA of Gabapentin?
Binds to presynaptic calcium channels/ limits release of NTs
Etanercept MOA?
Antagonist for TNF-Alpha
Denosumab MOA?
RANKL antibody(improves bone density)
Treatment with Denosumab?
- Osteoporosis
- Giant Cell Tumor
- Bone Metastases
- Multiple Myleoma
Osteoprotegrin MOA?
Does NOT directly bind RANKL, but rather competitively inhibits at level of receptor
Keller Arthroplasty?
Resection of bse of phalanx–> increased dorsiflexion during ambulation (tx of Wagner I ulcers after TCC unsucessful
MDM2 Gene associated with?
Atypical Lipomatous Tumor
Prophylactic fixation ishould be accompanied by_____ in metastatic cancer?
Radiation
Staging of agressive Soft Tissue sarcomas?
- Chest radiographs/Chest CT
- Locoregional Lymph node exam
- NOT NORMALLY whole body scan (accept Myxoid Liposarcomas)
Painful Symptoms associated with Ostoid Osteomas from ______
Prostoglandin E2
Ewing Sarcoma Tx:
- Multiagent Chemo
- Radiotherapy
- Surgery
Receptro That stimulates adipogenesis?
PPARy2
Tendon and ligament development receptor?
Scleraxis
Heparin MOA?
activation of AntiTHrombin II-III (AT II)
Major controlling mollecule for collagen fiber size?
Decorin
Molecule associated with elastin deposition?
Fibrillin
Molecule associated with tendon crimp?
Elastin
Slow twitch muscles use what during endurance training?
Glycogen AND Fatty acids
Molecule most responsible for hydration of intervertebral disk?
Aggrecan
What molecule has been used in VITRO to stimulat chondrogensis
TGF-BEta
Pagets disease of bone?
Osteoclasts alteered (possible viral), Increased AlkPhos, Increased bone resorption
Tendons Ligament Collagen?
Articular Cartilage Collagen?
- Type I
- Type II
Achondroplasia?
FGFR3 GAIN OF FUNCTION