Ortho

Question 1

What are the components of the Ottawa Knee Rules and what is it used for?

Answer 1

Knee X-ray indications after acute knee injury:
aged 55 years or over
tenderness at the head of the fibula
isolated tenderness of the patella
inability to flex knee to 90 degrees
inability to bear weight (defined as an inability to take four steps, ie. two steps on each leg, regardless of limping) immediately and at presentation

Question 2

6Ps of compartment syndrome / end arterial insufficiency

Answer 2

Pain, pallor, perishingly cold, paraesthesia, paralysis and pulselessness.

Question 3

Components of the Ottawa ankle and foot rules

Answer 3

Both: unable to weight bear for 4 steps

Ankle:
- pain at malleolar region
PLUS
- pain at posterior distal 6cm of tibia and/or fibula

Foot:
- pain in mid-foot region
PLUS
- pain at navicular and/or base of 5th metatarsal

Question 4

Exceptions of the Ottawa rules for imaging?

Answer 4

Intoxicated/decreased LOC
Distracting injuries
Diminished sensation - neuropathies etc.

Question 5

What are the NEXUS rules?

Answer 5

Used to see if C-spine imaging and collar is required

1+ of the following is positive:
Neurological deficit
Ethanol
Xtreme distracting injury 
Unable to respond (GCS <15)
Spinal midline tenderness