Ortho 4

Question 1

What are the causes of non-union?

Answer 1

Ischemia 
Infection 
Increased/ excessive interfragmentary strain 
Systemic disease
Smoking 
Tissue between the two opposing aspects

Question 2

What is meant by hypertrophic bone in a mal/ non-union?

Answer 2

The bone has become sclerotic and hardened off at the end rounding it.

Question 3

How can you remember salter harris - classification?

Answer 3

SALT Crush

• Straight pull away
• Above
• Low
• Through

Crush

Question 4

Where are the three places a fracture can occur intracapsular on the femur?

Answer 4

Subcapital
Transcervical
Basicervical

Question 5

What is the prognosis of a hip fracture?

Answer 5

30% mortality in 1 year

> 50% never regain full function

Question 6

What is the conservative management of a distal radial fracture?

Answer 6

Pain relief
Neurovascular status
Reduction

Back- slab cast
- re-xray.

If acceptable position then:

• 6 weeks cast + Physiotherapy
• seen in fracture clinic

Question 7

Which tendon is most likely to be injured following a distal radius fracture?

Answer 7

Extensor pollicis longus

Question 8

Where is a Bankart lesion and where is a Hillsachs lesion?

Answer 8

Bankart
- anterior-inferior labrum

Hillsach’s:
- Posterior-lateral part

Question 9

Specifically what is the pathology of a painful arc:

Answer 9

Entrapment of the supraspinatus tendon and subacromial bursa between the acromial and greater tuberosity of the humerus

Question 10

List some complications which can occur in femur and tibia fractures:

Answer 10

Hypovolaemic shock
Compartment syndrome
Fat embolism
Neurovascular damage

Question 11

What is the surgery for an ACL injury and what is the management prior to surgery?

Answer 11

Surgical:
- autograft repair using semitendinosus’ and gracilis

Prior:

• Physiotherapy to strengthen quads
• rest ICE

Question 12

What are some of the surgical options for OA?

Answer 12

Arthroscopic washout

• trim cartilage
• remove foreign bodies

Realignment ostomy
- Small bone area cut out - useful for <50 years old

Arthroplasty
- replacement

Arthrodesis

Question 13

Out with meniscus damage, what else may cause locking of the knee in a young person?

Answer 13

Osteochondritis dissecans

Question 14

Give several differentials for hip pain in a child:

Answer 14

DDH

Transient synovitis

Leg- Perthes disease

Septic Arthritis

JIA

Question 15

Name a condition which is associated with multiple enchondromas:

Answer 15

Ollier disease

Question 16

Out with foments sign for ulnar damage, what other finger movement can they not do?

Answer 16

Cross fingers - like crossing fingers for luck

Question 17

List some secondary causes of carpal tunnel syndrome:

Answer 17

Oedema 
Pregnancy 
Hypothyroidism 
Trauma 
Amyloidosis 
Acromegaly

Question 18

What is an early sign of carpal tunnel syndrome?

Answer 18

Loss of 2 point discrimination

Question 19

Which two branches of the median nerve may be injured during decompression of the carpal tunnel?

Answer 19

Palmar cutaneous branch

Motor branches

Question 20

What are the symptoms of a centrally prolapsed disc?

Answer 20

Bilateral sciatic pain
Reduce anal tone
Reduced perianal sensation
Urine retention/ incontinence

Question 21

What are the potential complications of disectomy?

Answer 21

Nerve root damage

Continual lower back pain

Question 22

What is usually the bone profile in osteoporosis and compare that to osteomalacia:

Answer 22

Osteoporosis is usually normal

Osteomalacia is usually abnormal

Question 23

What is the most common pathogen to cause osteomyelitis? And what are the investigations?

Answer 23

Staph aureus

FBC
CRP
BLOOD CULTURES

XRAY
MRI
BONE SCAN