orhto Flashcards
colles fracture
what nerve may be injured
FOOSH
dorsally displaced distal radius
dinner fork deformity
median nerve
boxer frac
punch hard surface like wall
= minimally displaced frac of 5th metacarpal
smiths frac
reverse colles
fall backwards onto palm of outstretched hand or
fall w wrists flexed
anterior displacement of frac
garden spade deformity
bartons frac
distal radius frac ie colles/smiths w associated radiocarpal dislocation
fall onto extended and pronated wrist
scaphoid frac presentation and intial mx
FOOSH
pain along radial aspect of the wrist, at the base of the thumb
loss of grip/ pinch strength
pain on ulnar deviation
futuro splint or standard below elbow backslab
refer ortho
garden classification of INTRACAPSULAR hip frac
- I – incomplete, non-displaced
- II – complete, non-displaced
III – partial displacement
IV – full displacement
garde class INTRACAPSULAR hip frac tx
I and II – internal fixation
III and IV – blood supply disrupted so needs to be removed and replaced:
Hemiarthroplasty – leaves acetabulum – limited mobility/co-morbidities
Total hip replacement – fit, can walk
Extracapsular frac of hip mx
blood supply remiains intact
Intertrochanteric – Dynamic hip screw
- Subtrochanteric – Intramedullary nail
hip frac presentation
shortened
abducted
externally rotated
how to measure pressure in compartment syndrome
needle manometry
acute compartment syndrome
pain on ankle dorsiflexion
after injury ie frac or crush
= faciotomy emergency
kaposi sarcoma
cancer caused by human herpes 8 (HHV8)
mc seen in pt end stage HIV
red/purple raised skin lesions skin and mucosa ie gi and resp tract
lesions may later ulcerate
resp involvement = massive haemoptysis and pleural effusion
radiotherapy and resection
meniscal tears presenation
twisting movements
pop sound
pain, gradual swelling, stiffness,
reduced ROM
locking giving way
meniscal tears ix and tx
1st = MRI
gold standard = arthroscopy
RICE
nsaids physio
ACL injury
twisting injury pain ‘pop’
rapid swelling
mri athroscopy
RICE nsaids, crutches, physio
athroscopic surgery
osgood schlatter age and what is it
10-15
inflam at tibial tub where patella ligament inserts
starts w tender lump –> hard non tender
pain anterior knee worse on excercise
frozen shoulder 3 phases
pain
stiffness (ext. rotation most affected)
thawing at 6 mths
rotator cuff injury ix
uss/mri
rotator cuff supraspinatus
abducts arm
rotator cuff innfraspinatus and teres minor
ext rotate arm
rotator cuff subscapularis
internally rotates arm
most common shoulder dislocation
anterior
should injury in seizure or electric shock
posterior shoulder dislocation
Medial epicondylitis
medial epicondyle usually flexes wrist
= golfers elbow
Lateral epicondylitis
later epi usually extends wrist
= tennis elbow (or house painting)
baker cyst ix
USS
achilles tendon rupture ix
USS
carpal tunnel ix
nerve conduction
iliotibial band syndrome
lateral knee pain in runners
tender 2-3cmm above later joint line
iliotibial band sndrome tx
activity modificatoon
iliotibial band stretches
doesnt improve = physio referal
prolapsed disc l5 root compression
sensoryy loss dorsum of foot
weakness in foot and big toe dorsiflex
normal reflexes
+ve siatic stretch test
plantar faciitus
mc cause of heel pain
pain worse around medial calcaneal tubersity
plantar faciitis mx
rest feet
shoes w good support and cushioned heels
insoled and heel pads maybe
causes of avasc necrosis of hip
long term steroids
chemo
alcohol excess
trauma
which nerves can be damaged in instrumental delivery
femoral
lumbosacral
sciatic
obturator
femoral nerve damage
week knee extension
loss of patella reflex
numbness of thigh
achilles tendon rupture examination
simmonds triad
fouchers sign
increase in tension of bakers cyst on extension of the knee
posterior hip dislocation presentation
MC dislocation
shortened
adducted
internally rotated
dupuytrens contracture
thickening of connective tissue in palm
ring finger and little finger curled
inability to flex fingers
causes of dupuytrens contracture
manual labour
phenytoin
alcoholic liver disease
DM
trauma
l4 nerve root compression
sensory loss
anterior aspect of knee and medial malleolus
weak knee extension hip adduction
reduced knee reflex
pt cant take alendronic acid bc gi pset 2nd line and 3rd line
2nd line risedronate or etidronate
3rd strontium ranelate or raloxifene
last = denosumab
what might ortho do with septic joint
joint washout
aspiration
debridement
rf for septic arthritis
penetrating injury
immunosupression
RA
DM
intrarticular injections
infection elsewhere ie gonnococcal
where does supraspinatus attach to humerus
greater tubercle
mc rotator cuff tear
how to assess
tears in supraspinatus tendon
MRI and US
supraspinatus intiates abduction for first 10-15 degrees then what takes over
deltoid
two muscles innervated by accesory nerve
teres minor and deltoid
