Ortho Flashcards
Cause of true leg length shortening
Fractured NOF Hip dislocation Growth disturbance of tibia/fibula e.g osteomyelitis or fracture Surgery e.g. Total hip replacement SUFE Perthes
Cause of apparent shortening of leg
Scoliosis of the spine
Feature of OA in hip
Pain
Stiffnes
Trendelenburg gait or positive trendenlburg test
Decreased range of motion - especially internal rotation
Fixed flexion deformity
Definition of osteoarthritis
Degenerative joint disorder in which there is progressive loss of hyaline cartilage and new bone formation at the joint surface and its margin
Risk of posterior approach - hip athroplasty
Higher dislocation rates than anterolateral
Injury to sciatic nerve - foot drop
Complication of anterolateral approach - hip athroplasty
Injury to superior gluteal nerve - trendenlburg gait
Complications of hip athroplasty
Immediate: nerve injury, fracture, cement reaction Early: DVT, deep infection, dislocation Late: - loosening - septic or aseptic - leg length discrepancy - metalosis - need for revision
Knee locking differential
Meniscal tear
Crucible ligament injury
Osteochondritis dissecans: adolescents
Loose body
Surgical management of ACL repair
Autograft repair - classically using semitendonous and gracillis
Aietology of hallux valgus
Familial tendency
Increased enclosed and pointed shoes
Associated with rheumatoid athritis
Surgical management of hallux valgus
Bunionectomy
1st metatarsal reallimgement surgery
Excision athroplasty
Definition of Charcot joints
Progressive destructive joint athropathy secondary to disturbance of the sensory innervation to the joint. It results in a painless deformed joint resulting from repatitive minor trauma
Cause of Charcot joints
Peripheral: DM, peripheral never Injury, leprosy
Central: syringomyelia, tabes dorsalis
Definition of a bakers cyst
Posterior herniation of knee joint capsule
Cause of winging of the scapula
Long thoracic nerve damage
Upper brachial plexus injury
Muscular dystrophy
Froment test
Flexion of thumb at IPJ - weak adductor policis
Indicates ulnar nerve lesion
Contents of the carpal tunnel
4 tendon of FDS
4 tendon of FDP
1 tendon of flexor palmaris longus
Median nerve
Muscle in hands innervates by median nerve
Lateral two lumbricals
Oppens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Cause of carpal tunnel syndrome
Idiopathic - commonest Water: pregnancy, hypothyroidism Radial fracture Inflammation: RA, gout Soft tissue swelling: lipomas, acromegaly,Amyloidosis Toxic: diabetes melitus, EtOH
Cause of a positive trendelenburg test
Abductor wasting secondary to chronic pain
Superior gluteal nerve injury
Structural - developmental dysplasia of the hip