Ortho

Question 1

Fracture management principles

Answer 1

4Rs
Resuscitation
Reduction
Restriction
Rehabilitation

Question 2

Common palsy after anterior shoulder dislocation

Answer 2

Axillary nerve palsy
Sargeant’s patch numbness
weak abduction

Question 3

Common palsy after humeral neck fracture

Answer 3

Axillary nerve palsy
Sargeant’s patch numbness
weak abduction

Question 4

Common palsy after elbow dislocation

Answer 4

Ulner nerve palsy
claw hand

Question 5

Common palsy after hip dislocation

Answer 5

Sciatic nerve palsy
foot drop

Question 6

Common palsy after knee dislocation

Answer 6

Sciatic nerve palsy
foot drop

Question 7

Common palsy after neck of fibula fracture

Answer 7

Sciatic nerve palsy
foot drop

Question 8

Causes of non- or mal-union

Answer 8

5 Is
* Ischaemia: poor blood supply or AVN
* Infection
* ↑ interfragmentary strain
* Interposition of tissue between fragments
* Intercurrent disease: e.g. malignancy or malnutrition

Question 9

Common sites of avascular necrosis of bone

Answer 9

femoral head, scaphoid, talus

Question 10

Salter Harris Classification

Answer 10

• I - Straight across
• II - Above
• III - Lower
• IV - Through
• V - CRUSH

Question 11

Osteoporosis risk factors

Answer 11

Age + SHATTERED
* Steroids
* Hyper- para/thyroidism
* Alcohol and Cigarettes
* Thin (BMI<22)
* Testosterone low
* Early Menopause
* Renal / liver failure
* Erosive / inflame bone disease (e.g. RA, myeloma)
* Dietary Ca low / malabsorption, DM

Question 12

Types of intracapsular NOFs

Answer 12

subcapital
transcervical
basicervical

Question 13

Types of extracapsular NOFs

Answer 13

intertrochanteric
subtrochanteric

Question 14

Blood supply to femoral head

Answer 14

Retinacular vessels in capsule
Intramedullar vessels
Ligamentum teres

Question 15

Garden classification of NOF

Answer 15

o 1 = incomplete #, undisplaced
o 2 = complete #, undisplaced
o 3 = complete #, partially displaced
o 4 = complete #, completely displaced

Question 16

Surgical treatment of NOF

Answer 16

intracapsular fractures
Garden 1 & 2: ORIF w cancellous screws
Garden 3 & 4:
< 55 yrs: ORIF w screws in young, active pts, F/U & in case of AVN
55-75 yrs: THR in pts
> 75 yrs: hemiarthroplasty
extracapsular fractures: ORIF
extramedullary: sliding screw & plate = DHS
intramedullary: Gamma nail implants

Question 17

Radiographic features of Colles’ fracture

Answer 17

transverse fracture of radius
dorsal displacement of distal fragment w dorsal angulation
normally 1 inch proximal to radio-carpal joint
± avulsion of ulnar styloid
± impaction

Question 18

Scaphoid fracture management

Answer 18

place wrist in scaphoid plaster (beer glass position)
if initial XR -ve, pt. returns to # clinic after 10 days for repeat XR
o # visible -> plaster for 6 wks
o no visible # but clinically tender -> plaster for 2 wks
o no visible # & not clinically tender -> no plaster

Question 19

Deformity complication of supracondylar humerus fracture

Answer 19

Gunstock deformity

Question 20

Gunstock deformity

Answer 20

cubitus varus deformity

Question 21

Differentials of painful arc

Answer 21

• Impingement
• Supraspinatus tear or partial tear
• AC joint OA

Question 22

Monteggia’s fracture

Answer 22

proximal ulnar fracture associated w dislocation of proximal radioulnar joint

Question 23

Galeazzi fracture

Answer 23

distal radial shaft fracture w associated dislocation of distal radioulnar joint