orhto

Question 1

colles fracture

what nerve may be injured

Answer 1

FOOSH

dorsally displaced distal radius
dinner fork deformity

median nerve

Question 2

boxer frac

Answer 2

punch hard surface like wall

= minimally displaced frac of 5th metacarpal

Question 3

smiths frac

Answer 3

reverse colles
fall backwards onto palm of outstretched hand or
fall w wrists flexed

anterior displacement of frac
garden spade deformity

Question 4

bartons frac

Answer 4

distal radius frac ie colles/smiths w associated radiocarpal dislocation

fall onto extended and pronated wrist

Question 5

scaphoid frac presentation and intial mx

Answer 5

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

Question 6

garden classification of INTRACAPSULAR hip frac

Answer 6

• I – incomplete, non-displaced
• II – complete, non-displaced

III – partial displacement
IV – full displacement

Question 7

garde class INTRACAPSULAR hip frac tx

Answer 7

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

Question 8

Extracapsular frac of hip mx

Answer 8

blood supply remiains intact

Intertrochanteric – Dynamic hip screw
- Subtrochanteric – Intramedullary nail

Question 9

hip frac presentation

Answer 9

shortened
abducted
externally rotated

Question 10

how to measure pressure in compartment syndrome

Answer 10

needle manometry

Question 11

acute compartment syndrome

Answer 11

pain on ankle dorsiflexion
after injury ie frac or crush

= faciotomy emergency

Question 12

kaposi sarcoma

Answer 12

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

Question 13

meniscal tears presenation

Answer 13

twisting movements
pop sound
pain, gradual swelling, stiffness,
reduced ROM
locking giving way

Question 14

meniscal tears ix and tx

Answer 14

1st = MRI
gold standard = arthroscopy

RICE
nsaids physio

Question 15

ACL injury

Answer 15

twisting injury pain ‘pop’
rapid swelling

mri athroscopy

RICE nsaids, crutches, physio
athroscopic surgery

Question 16

osgood schlatter age and what is it

Answer 16

10-15
inflam at tibial tub where patella ligament inserts
starts w tender lump –> hard non tender
pain anterior knee worse on excercise

Question 17

frozen shoulder 3 phases

Answer 17

pain
stiffness (ext. rotation most affected)
thawing at 6 mths

Question 18

rotator cuff injury ix

Answer 18

uss/mri

Question 19

rotator cuff supraspinatus

Answer 19

abducts arm

Question 20

rotator cuff innfraspinatus and teres minor

Answer 20

ext rotate arm

Question 21

rotator cuff subscapularis

Answer 21

internally rotates arm

Question 22

most common shoulder dislocation

Answer 22

anterior

Question 23

should injury in seizure or electric shock

Answer 23

posterior shoulder dislocation

Question 24

Medial epicondylitis

Answer 24

medial epicondyle usually flexes wrist

= golfers elbow

Question 25

Lateral epicondylitis

Answer 25

later epi usually extends wrist = tennis elbow (or house painting)

Question 26

baker cyst ix

Answer 26

USS

Question 27

achilles tendon rupture ix

Answer 27

USS

Question 28

carpal tunnel ix

Answer 28

nerve conduction

Question 29

iliotibial band syndrome

Answer 29

lateral knee pain in runners tender 2-3cmm above later joint line

Question 30

iliotibial band sndrome tx

Answer 30

activity modificatoon iliotibial band stretches doesnt improve = physio referal

Question 31

prolapsed disc l5 root compression

Answer 31

sensoryy loss dorsum of foot weakness in foot and big toe dorsiflex normal reflexes +ve siatic stretch test

Question 32

plantar faciitus

Answer 32

mc cause of heel pain pain worse around medial calcaneal tubersity

Question 33

plantar faciitis mx

Answer 33

rest feet shoes w good support and cushioned heels insoled and heel pads maybe

Question 34

causes of avasc necrosis of hip

Answer 34

long term steroids chemo alcohol excess trauma

Question 35

which nerves can be damaged in instrumental delivery

Answer 35

femoral lumbosacral sciatic obturator

Question 36

femoral nerve damage

Answer 36

week knee extension loss of patella reflex numbness of thigh

Question 37

achilles tendon rupture examination

Answer 37

simmonds triad

Question 38

fouchers sign

Answer 38

increase in tension of bakers cyst on extension of the knee

Question 39

posterior hip dislocation presentation

Answer 39

MC dislocation shortened adducted internally rotated

Question 40

dupuytrens contracture

Answer 40

thickening of connective tissue in palm ring finger and little finger curled inability to flex fingers

Question 41

causes of dupuytrens contracture

Answer 41

manual labour phenytoin alcoholic liver disease DM trauma

Question 42

l4 nerve root compression

Answer 42

sensory loss anterior aspect of knee and medial malleolus weak knee extension hip adduction reduced knee reflex

Question 43

pt cant take alendronic acid bc gi pset 2nd line and 3rd line

Answer 43

2nd line risedronate or etidronate 3rd strontium ranelate or raloxifene last = denosumab

Question 44

what might ortho do with septic joint

Answer 44

joint washout aspiration debridement

Question 45

rf for septic arthritis

Answer 45

penetrating injury immunosupression RA DM intrarticular injections infection elsewhere ie gonnococcal

Question 46

where does supraspinatus attach to humerus

Answer 46

greater tubercle

Question 47

mc rotator cuff tear how to assess

Answer 47

tears in supraspinatus tendon MRI and US

Question 48

supraspinatus intiates abduction for first 10-15 degrees then what takes over

Answer 48

deltoid

Question 49

two muscles innervated by accesory nerve

Answer 49

teres minor and deltoid