Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD Finals > Ortho > Flashcards

Ortho Flashcards

1
Q

What is a fracture?

A

Break in the continuity of a bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a colles fracture?

A

Distal radius +/- ulnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Smith fracture?

A

Distal radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a Monteggias fracture?

A

Proximal 1/3 ulnar and dislocation radial head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a Galeazzi fracture?

A

Radial distal shaft and dislocation of radioulnar joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a boxer’s fracture?

A

5th metacarpal bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the presentation of a fracture?

A

Pain, swelling, deformity, neurovacsular disturbance, palpable step-off or gap, soft tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a fracture Dx on X-Ray?

A

2 views, 2 joints, pre- and post-reduction
Radio-lucent line
Cortical disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General principles of fracture management?

A

Analgesia
Wound care
Assessment of VTE risk
Fracture care - Reduction, fixation (open/closed), rehab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Immediate complications fractures?

A

Pain
Nerve/skin damage
Fat embolus
Soft tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Early complications of a fracture?

A

Compartment syndrome
Infection
DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Late complications of a fracture?

A 
Stiffness
Complex regional pain syndrome
Malunion - abnormal position
Delayed union - longer than  expected
Non-union - not healing after expected time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mx Dislocation

A

Reduction - closed if possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mx Open Fracture

A 
Tetanus
IV Abx
Photos of wound to prevent taking off dressings
Saline-soaked gauze
Ortho  and plastics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mx Compartment Syndrome

A

Fasciotomy, cool and position limb

Analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mx Vascular Injury

A

Angiography +/- Repair +/- Fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the Gustilo-Anderson Classification of Open Fractures

A

Type 1: Clean, low energy wound < 1cm
Type 2: 1-10cm, moderate damage
Type 3: >10cm, high energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is compartment syndrome?

A

Pressure in fascial compartment leads to impaired tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of Compartment syndrome?

A

Burns, fracture haematoma, constrictive bandages, reperfusion syndrome

Pathology - Compartment pressure > capillary pressure
–> Ischaemia –> Oedema and increased pressure –> cycle continues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the clinical features of compartment syndrome?

A

Pain out of proportion
Pain on passive stretching
Palpable tense compartment
Pulselessness - late –> 6Ps ischaemic limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DDx Compartment Syndrome?

A

Rhabdomyolysis - High CK, LDH, myoglobin
DVT
Acute limb ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Septic Arthritis Aetiologies

A

Haematogenous/Direct spread

S Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical Features Septic Arthritis

A

Acute onset
Mono-arthropathy
Triad - fever, pain, decreased RoM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ix Septic Arthritis

A

US-guided arthrocentesis - WCC >50 - yellow/green - send for biorefringence (gout)
Sepsis 6
Bloods - U&Es (urate)
Urethral, cervical and anorectal swabs - gonorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

DDx Septic Arthritis

A

Gout
Pseudogout
OA
Haemarthrosis if anticoagulated in reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mx Septic Arthritis

A

Abx for 2 or more weeks - Vanc/Ceftriaxone
Aspirate and drain
PTx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Complications Septic Arthritis

A

Joint destruction
Osteomyelitis
Sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Acute causes of Spinal Cord Compression

A 
Minutes - hours
Fracture
Herniation
Trauma
Haematoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Insidious Causes of Spinal Cord Compression

A

Tumour
Abscess
Degenerative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ix Spinal Cord Compression

A

MRI Spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Clinical Features Spinal Cord Compression

A

Back/radicular pain
Neuro deficits below level of lesion
Sensory before motor
Painless retention and increased reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mx Spinal Cord Compression

A

Steroids - IV
Opioids
Decompression and stabilisation definitive
Inoperative - RTx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Mx of a Spinal Abscess

A

IV Abx

Drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Mx for Spine Mets

A

Steroids
RTx
Decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the cauda equina?

A

Nerve roots of Lumbar, sacral and coccyx spinal nerves
Supplies lower limbs, perineum and pelvic organs
Internal and external anal sphincter
Parasympathetic to bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the Conus Medullans

A

Caudal end of spinal cord - ends at L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the cause of a Cauda equina syndrome?

A

Damage/compression of cauda equina (nerve roots L3-S5)
Trauma
Tumour
Large posteromedial disc herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Clinical features of a Cauda equina syndrome?

A

Gradual unilateral, severe radicular pain
Motor: asymmetrical leg reflexes - hypo to areflexic (LMN)
Sensory: Saddle anaesthesia, asymmetrical paraesthesia and numbness
Neurogenital: urinary retention, altered rectal tone, erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Ix Cauda equina syndrome?

A

MRI within 4h to identify nature and site of lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mx Cauda equina syndrome?

A

Surgery

Metastatic –> RTx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is Carpal Tunnel Syndrome?

A

Peripheral neuropathy caused by acute or chronic compression of median n, deep to flexor retinaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the pathology in Carpal Tunnel Syndrome?

A

Carpal tunnel has carpal bones below and transverse carpal lig above
Contains flexor tendons and median n
Raised P compresses structures within
–> Decreased blood flow and axonal degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Causes of a Carpal Tunnel Syndrome?

A

Distal radial fracture
DM
RA
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Clinical Features of a Carpal Tunnel Syndrome?

A 
Palmar aspect of thumb, index, middle and radial half ring finger
Burning
Numbness 
Loss of sensation 
Worse at night
Altered/weakened pinch grip
Thenar atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Ix of Carpal Tunnel Syndrome?

A

Tinnel’s sign - Repeatedly tap over
Phalen’s signs - Wrist in full flexion - Inverse prayer
NCS - prolongation in motor and sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Mx of Carpal Tunnel Syndrome?

A

Conservative: Immobilise, steroid injection and NSAIDs
Surgery: Median nerve decompression - release of transverse carpal lig, and flexor retinaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is Flexor Tenosynovitis?

A

Inflammation tendon and synovial sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cause of Flexor Tenosynovitis?

A

Overuse or systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is Dupytren’s Disease?

A

Common fibroproliferative disorder of the palmar fascia of the fourth and fifth fingers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the pathology of Dupytren’s Disease?

A

Fibroproliferative disorder
Nodules adhere to overlying dermis
Leads to characteristic skin puckering
Nodules then lead to cords, and contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Clinical Features of Dupytren’s Disease?

A

Skin tethering near the proximal flexor crease of the fourth and fifth fingers
Palmar nodules in cords
Fixed contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Ix for Dupytren’s Disease?

A

BM

LFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Mx Dupytren’s Disease?

A

Conservative: Splint and PT
Medical: Intra-lesional steroid injections; PO Steroids; Collagenase injection
Surgery: Fasciotomy or fasciectomy if functional disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the surgical neck of the humerus?

A

Circumferential constriction between the tubercles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What runs in surgical neck of humerus?

A

Axillary n.

Circumflex humeral vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the mechanism of injury to the surgical neck of humerus?

A

Common in elderly - OP

High velocity FOOSH in young

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How are fractures to surgical neck of humerus classified?

A

Via Neer’s classification
Defines comminution
Anatomical neck, shaft, greater- and lesser tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How to Dx surgical neck of humerus fracture?

A

AP and lateral X-Rays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

X-Ray findings in supracondylar fracture?

A 
Sail sign (ant fat pad)
Posterior fat pad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Mx of surgical neck of humerus fracture?

A

Conservative: Collar and cuff (non-displaced, closed)
Surgical: (displaced, comminuted) ORIF or Hemiarthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Complications of surgical neck of humerus fracture?

A

Adhesive capsulitis
AVN humeral head (axillary a. injury)
Axillary n. palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

3 Signs of an Axillary n. palsy?

A

Flat deltoid
Decreased sensation over regimental badge area
Reduced shoulder abduction to 15 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Complications of Humeral Shaft Fracture?

A

Wrist drop - Radial n. palsy –> Decreased wrist strength and decreased sensation over dorsal hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Complications of Distal Humeral Fracture?

A

Brachial a. injury common

Radial/ulnar/median n. palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Most common joint dislocation?

A

Shoulder

Ant > Post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Causes of Shoulder Dislocation?

A

Head humerus larger than glenoid fossa
FOOSH
Recurrent dislocation - loose capsule and ligament damage
Post - Seizures and shocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

2 Lesions on X-Ray in shoulder dislocation

A

Hill-sach’s - Depression fracture humeral head

Bankart lesion - Damage to ant labrum head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Classification of Shoulder Dislocation

A

Anterior
- Subcoracoid:
- Subglenoid:
Posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Classification of Humeral Shaft/Diaphysis Fracture

A

According to Prox, middle, or distal 1/3

Or based on comminution - none (A), Butterfly (B), Proper comminution (C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Presentation of a Shoulder Dislocation

A

Severe shoulder pain
Decreased RoM
Signs: Loss deltoid contour, Internally rotated and abducted is post disl., ant = abducted and external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the most important aspect of Shoulder Dislocation Examination?

A

Neurovascular status - axillary n. and radial a. function prior to reduction
Regimental badge area, dorsal hand sensation and pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Ix for Shoulder dislocation

A 
2 View Shoulder X-Ray - AP and Y view 
To exclude fracture
Hill-sachs - Humeral  head dents glenoid
MRI - Bankart 
Anterior - 95% cases; Sit in front of  acromion 
Posterior - Lightbulb sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Mx Shoulder Dislocation

A

Immobilise with sling/splint
Reduction (Closed before open)
Surgery > Conservative - if failed closed; fracture; Hill-Sach lesions or neurovascular injury; posterior dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Most common joint dislocations

A

1 - Shoulder

2 - Elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Causes of an elbow dislocation?

A

Trauma - FOOSH

Pulled elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Classification of elbow dislocation?

A

Posterior - 90%

Anterior - 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Clinical features of an elbow dislocation?

A 
Pain and swelling
Decreased RoM
Prominent olecranon process
Limb length discrepancy
Nerve injury - any of 3
Lost triangle of med/lat epicondyle and olecranon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

How is an elbow dislocation diagnosed?

A

2 View X-Ray - AP/Lateral
Exclude fracture
Posterior fat pad sign if fracture present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Mx of an elbow dislocation?

A

No fracture - closed reduction & immobilise

Fracture/instability - ORIF or closed in theatre setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Epidemiology of a Distal Radial Fracture?

A

Bimodal peak incidence - 10-30, >65y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Aetiology of a Distal Radial Fracture?

A

High energy trauma in males (FOOSH)
Osteoporotic-related, low energy trauma
Fall on dorsi-flexed hand = Colles’
Fall on palmar-flexed = Smith’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Classification of Distal Radial Fractures?

A 
Colles' = Dorsal angulation and shortening distal fragment
Smith's = Volar angulation and shortening distal segment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Clinical Features of a Distal Radial Fracture?

A 
Tender, soft swelling at wrist
Decreased RoM 
Deformity
Colles' = Dorsal displacement and dinner fork deformity (Z)
Smith's = palmar kink
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Ix of a Distal Radial Fracture?

A

3 view X-Ray - AP, Lateral and Oblique

Examine joint above and below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

3 DDx of a Distal Radial Fracture?

A

Scaphoid
Greenstick
Monteggia
Galeazzi

86
Q

Most commonly fractured carpal bone?

A

Scaphoid - Middle 1/3

87
Q

Mechanism of injury in Scaphoid Fracture?

A

FOOSH + hyperextended and radially deviated wrist

88
Q

Clinical Features of a Scaphoid Fracture?

A 
Wrist pain and swelling 
Pain over anatomical snuff box and scaphoid tubercle
Pain on telescoping thumb
Slight decreased RoM
Painful pinching/grasping
89
Q

Ix of a Scaphoid Fracture?

A

4 views - Scaphoid views

PA, lateral, 45, oblique

90
Q

Significance of a normal X-Ray in a Scaphoid Fracture?

A

1/4 undetectable - immobilise and re-assess in 2/52

91
Q

Mx of a Scaphoid Fracture?

A

Pain management
Undetectable, re-exam in 2 weeks
Immobilise: with a thumb spica or plaster
Surgery indications: Open fracture, evidence osteonecrosis or highly displaced
Surgery: Screw fixation

92
Q

Complications of a Scaphoid fracture?

A

Proximal AVN - blood supply enters distally

Subsequent non-union/delayed union; post-traumatic arthritis

93
Q

What is a Bennet’s fracture?

A

Most common thumb injury

Intra-articular fracture at base of 1st metacarpal with CMC subluxation

94
Q

Mx of a Bennet’s fracture?

A

Closed manipulation and immobilisation

If fails - K wire

95
Q

What is the cause of a Boxer’s fracture?

A

Striking solid object with closed fist - impact on 5th knuckle/metacarpal

96
Q

Mx of a Boxer’s fracture?

A

Conservative
Splinting
Surgical: Make fist - if fingers overlap - surgery as means rotation or shortening

97
Q

Mx of phalangeal fractures?

A

Conservative: Buddy tape or splint
Surgical: Closed reduction, percutaneous pinning or ORIF

98
Q

What is the position of safety (phalangeal fracture)?

A

Flexed MCPs and extended PIP (crocodile hand)

99
Q

What is the function of the position of safety (hand)?

A

Safe immobilisation of hand and prevent contracture formation

100
Q

RFx for a NOF?

A 
OP
Elderly
Impaired co-ordination
Low Vit D
Smoking
Alcohol
Muscle Weakness
101
Q

Classification of a NOF?

A 
Intra-capsular:
- Displaced
- Non-displaced 
Extra-capsular:
- Intratrochanteric 
- Subtrochanteric
102
Q

What is the significance of an intra-capsular NOF?

A

AVN - blood to femoral head disrupted

103
Q

What are the clinical features of a NOF?

A

Groin pain
Inability to weight bare
Shortened and externally rotated hip

104
Q

Ix for NOF?

A

MRI = gold standard
CT = 2nd best
Diagnosed on X-Ray - 2 views - AP/Lateral
If ?pathological fracture - X-Ray femur

105
Q

When should a NOF be taken to theatre?

A

Within 48h unless medical cause that requires reversal - 36h

106
Q

When would conservative Mx be offered in NOF?

A

Not fit for anaesthetic

107
Q

Who is involved in post-op Mx of NOF?

A 
PT
OT
Social work
Family
Orthopod
Geriatrician
108
Q

What is the Mx of an extracapsular NOF?

A

DHS (preferred) or IM nail

109
Q

What is the Mx of an intracapsular NOF?

A

Old - hemi

Young - Total

110
Q

3 Criteria for Hip replacement

A

Medically fit
No cognitive impairment
Mobilise outdoor with sticks or less

111
Q

Complications of a hip replacement

A

General: AVN, VTE, infection
Hemi: Leg length discrepancy
DHS: failure of metalwork

112
Q

How to prevent NOF?

A

Adequate OP prophylaxis
Falls risk assessment
Falls training - remove trip hazard, wear good shoes

113
Q

RFx for OP?

A 
Elderly
Female
Post-menopausal
Steroid use/PPI
Alcohol, smoking and malnutrition
114
Q

What does a DEXA scan do?

A

Calculates BMD and gives answer as T-Score

115
Q

Grade T-Scores

A

-1 to -2.5: Osteopenia

< -2.5: OP

116
Q

Causes of a pelvic fracture?

A

High energy: bike accidents, crashes, crushes - unstable

Low energy: Osteoporotic falls - stable

117
Q

Clinical Features of a pelvic fracture?

A 
Pelvic pain
Worse on compression iliac crest
Leg length discrepancy
Instability 
Tilted pelvis 
Haematoma
118
Q

How to test for pelvic instability?

A

Hands on both ASIS - apply downward pressure - Springy resistance AKA organs

119
Q

Common co-presenting injuries to pelvic fracture?

A

Urethral injury
Bladder injury
Neurovascular injury

120
Q

Ix for pelvic fracture?

A

Pelvic X-ray - AP inlet and outlet views
CT in stabilised patients
Angiography in haemorrhages
Retrograde urethrogram - only suprapubic catheter in people with pelvic fracture

121
Q

Mx of pelvic fracture?

A 
Resus and stabilisation
Application of pelvic binder
Conservative: bed rest and PT
Surgery: for unstable and open fractures
- Stabilise and fix with ORIF/ external fixation
122
Q

Complications of pelvic fracture?

A

Haemorrhagic shock
Intra- and retroperitoneal bleeding
Abdo compartment syndrome (>7mmHg)

123
Q

Hip Dislocation

A

Posterior 90%

  • Associated with femoral head fractures
  • Causes: Dashboard injury, Forces against internally rotated, adducted and flexed hip
  • Presentation: Hip pain, shortened, internally rotated and adducted hip
  • Management: Closed reduction (decreases risk osteonecrosis), ORIF if closed fails
  • Complications: Sciatic and perineal n. injury

Anterior 10%

  • Blow to posterior hip
  • Lengthened, externally rotated hip
  • Complications: Femoral n. injury
124
Q

Femoral n. injury S&S

A

Sensory loss and paresis over anteromedial lower limb

Decreased hip flexion and knee extension

125
Q

Why are knee dislocations under reported?

A

They self reduce

Being obese RFx

126
Q

Causes of a knee dislocation?

A

High energy - RTA; dashboard and crush injuries

Obesity + walking - low energy

127
Q

Clinical features of a knee dislocation?

A

Knee pain and instability
Deformity
Dimple sign - medial fem condyle pokes through medial capsule
Vascular injury - immediate reduction (popliteal)

128
Q

Ix for a knee dislocation?

A

AP and Lateral + 45 degree oblique if ?fracture

May also have avulsion fracture/ asymmetrical joint space

129
Q

Mx for a knee dislocation?

A

Conservative: Closed reduction + Vasc assessment
Most require theatre stabilisation
Surgical: ORIF / External fixation (compartment) + Ligament repair

130
Q

Causes of Femoral Shaft Fractures?

A

High impact trauma - RTA

Low impact trauma - Fall from standing (<1m)

131
Q

Clinical Features of a Femoral Shaft Fractures?

A 
Painful, swollen and tense thigh 
Haematoma 
Reduced RoM
Shortening
Distal NV deficits 
FAT EMBOLI - Change mental status, SoB, Hypoxia, Petechiae
132
Q

Ix of Femoral Shaft Fractures?

A

Plain X-Ray unless suspect pathological

133
Q

Mx of Femoral Shaft Fractures?

A

Emergency - skin traction and long-leg post splint

Definitive - IM rod with interlocking nail or External fixation then an IM nail

134
Q

Classification for Tibial Plateau Fracture?

A

Schatzker Classification

135
Q

Most common long bone Diaphyseal Fracture?

A

Tibial

136
Q

3 kinds of Tibial Fracture?

A

Proximal/Plateau
Shaft
Distal

137
Q

Classification of Tibial Fractures?

A

Isolated
Combined tib/fib
Plateau

138
Q

Clinical Features of Tibial Fractures?

A

Fracture signs - Pain, swelling, reduced RoM

Tibial Plateau have high risk open fracture and compartment syndrome

139
Q

Why do Tibial Fractures have high risk open fracture?

A

Min soft tissue

140
Q

Why do Tibial Fractures have high risk compartment syndrome?

A

Surrounded by all 4 of the anterior, lateral, deep and superficial

141
Q

Ix for Tibial Fracture?

A

X-Ray - knee and ankle
2 views
Lipohaemarthrosis fat fluid level (plateau)
Aspiration - haemarthritic material with fatty spots (in osteochondral plateau fracture)
Consider MRI - ligamentous/ meniscal injury

142
Q

Mx for Tibial Fracture?

A

Conservative: Fibula - Splint; Prox tibia - Hinged knee brace; Shaft - Long-leg cast
Surgical: If open or displaced - irrigation, debridement, ORIF/Ex Fixation

143
Q

Complications of Tibial Fracture?

A

Compartment syndrome - kept for overnight watch
Fat embolism
Peroneal n. injury - foot drop

144
Q

Cause of Ankle Fractures

A

Supination or pronation - twisted ankle

145
Q

Classification of Ankle Fractures

A

Weber - According to level of fibula fracture, related to level of syndesmosis
Weber A - Below (intact)
Weber B - At level of (?injury)
Weber C - Above (Injury - ruptured syndesmosis and torn interosseous membrane)

146
Q

What is a Maisonneuve fracture?

A

Weber C (Ruptured syndesmosis and torn interosseous membrane) + Medial malleoulous fracture + deltoid ligament tear

147
Q

How can ankle fractures be classified by stability?

A

Isolated medial/lateral malleolous –> Stable
Posterior Medial Malleolous –> Unstable
Bimalleolar - Unstable
Trimalleolar (Med/Lat/Post medial) - Unstable

148
Q

What is Volkmann’s triangle?

A

Avulsion fracture from posterior tibia (medial)

149
Q

What is a Pilon fracture?

A

Fracture of distal tibia and part of talocrural joint

Associated with fibular fracture

150
Q

Clinical Features of an Ankle fracture?

A

Pain
Swelling
Haematoma
Tenderness over malleoli, syndesmosis or posterior ankle joint
Skin abnormalities - discolouration, bruising, tenting

151
Q

Mx of Ankle Fractures

A

RICE - Rest, Ice, compression, elevation
Emergency - Reduction, backslab (sedate)
Weber A- Ankle support brace
Weber B - Operative fix if evidence of talar shift
Weber C - Operative fix (reposition, ORIF, or ex fix)

152
Q

What is Talar Shift?

A

When talus no longer aligned with tibial articular surface on a mortice view

153
Q

What is most common injury of foot?

A

Metatarsal fracture (5th most common, 2nd due to stress)

154
Q

Causes of metatarsal fracture?

A

Crush injury

155
Q

Clinical features metatarsal fracture?

A

Pain
Inability to weight bare
Tenderness

156
Q

Important factors in metatarsal fracture?

A

Evaluation of soft tissue injury
Malrotation and overlapping
Monofilament for neurovascular status

157
Q

Mx of a metatarsal fracture?

A

Goals - maintain foot arches, restore alignment
Conservative: Stiff toed shoes if weight baring tolerated
Surgery: If displacement - pinning (percutaneous or ORIF)

158
Q

Associated conditions with metatarsal fractures?

A

Stress fractures

Lisfranc fracture

159
Q

What is a Lisfranc injury?

A

Tarso-metatarso fracture dislocation

Disruption between articulation between cuneiform and 2nd metarsal head.

160
Q

Cause of Lisfranc?

A

MVA
Fall from heigh
Athletic injuries
(High energy)

161
Q

Clinical features of a Lisfranc?

A 
Severe pain 
Inability to weight bear 
Medial plantar bruising 
Mid foot swelling 
Tenderness over TMT joint 
Intability tests
162
Q

What are the instability tests for Lisfranc injuries?

A

Metatarsal squeeze test

Dorsal subluxation

163
Q

Talar dislocation.

A

Rare.
High energy.
Medial - locked in supination.

164
Q

How can you classify rotator cuff disorders?

A

Greater tuberosity
Supraspinatus - Abduction (before deltoid, 15 degrees)
Infrarpinatus - ex rotation
Teres Minor - ex rotation

Lesser tuberosity
Subscapularis - int rotation

165
Q

What is the pathology of calcifying tendotinits?

A

Calcium deposits most commonly in supraspinatus tenson

166
Q

Clinical features of calcifying tendonitis?

A

Asymptomatic
Acute or chronically painful shoulder
Worse with activity

167
Q

Investigations for calcifying tendonitis?

A

X-ray shows calcium deposits in the tendon

168
Q

Management of calcifying tendonitits?

A

Majority resolves with conservative management

169
Q

What is chronic tendonitits?

A

AKA Impingement Syndrome

Tendon is compressed against the coracoacromial arcj

170
Q

Clinical features of impingement?

A

Gradual onset

Pain with overhead activities

171
Q

Management of impingement?

A

Conservative - physio, NSAIDs, subacromial steroid injection

Operative - subacromial decompression +/- tendon repair

172
Q

How does a biceps tendon rupture present?

A

Usually rupture of long head of biceps
Popeye sign with muscle contraction
Visible bulge in the middle of biceps due to retraction of ruptured tendon

173
Q

What are the 3 stages of adhesive capsulitis?

A

Painful phase - night pain, gradual onset

Frozen phase - progressive decreased ROM, esp ER

Thawing phase - progressive increased ROM and pain

174
Q

Clinical Features of adhesive capsulitis?

A

Reduced RoM - ex Rotation

175
Q

Ix adhesive capsulitis?

A

X-ray - exclude other Dx

176
Q

Mx adhesive capsulitis?

A

Analgesia
Steroid injections
PT
Consider arthroscopy for resistant cases

177
Q

Mx for Hip OA

A

THR/Hemi

178
Q

Two kinds of knee replacement?

A

Constrained

Non-constrained - TKR

179
Q

RFx for Hip AVN

A 
Irradiation
Trauma
Haematological malignancy
Decompression sickness
Alcoholism
Steroids
180
Q

Clinical Features in <6m with DDH

A

Barlow and Ortolani

181
Q

Clinical features of DDH 6-18m

A

Asymmetrical gluteal folds

Inability to abduct hip

182
Q

Clinical features DDH >18m

A

Waddling trendelenberg gait

Leg length discrepancy and pain

183
Q

Ix DDH

A

< 4m - USS

>4m - X-ray

184
Q

Mx DDH

A

<6m - Brace/Pivlik harness

>6m - Closed reduction and spica cast

185
Q

Cause of Quads tendon rupture

A

Contraction of quads when knee partly flexed and foot planted

186
Q

Clinical Features of Quads tendon rupture

A

Pain and swelling knee joint
Palpable gap tendon
Inability to flex knee

187
Q

Mx Quads tendon rupture

A

Surgical suturing

188
Q

Causes Patella tendon rupture

A

Trauma to infrapatellar region

189
Q

Clinical Features of Patella tendon rupture

A

Pain, swelling, palpable gap

High riding patella

190
Q

Mx of Patella tendon rupture

A

Partial tears - immobilise

Complete tears - suture

191
Q

Clinical Features of Meniscal tear

A

Clicking, locking, popping
Effusion
Medial > Lateral

192
Q

How to differentiate meniscal tear from ligament damage

A 
Pop = Ligament 
Lock = meniscus
193
Q

Mx Meniscal tear

A

RICE
NSAIDs
PT
Arthroscopy

194
Q

Knee ligament Causes and RFx

A

ACL >PCL
Females
Audible pop

195
Q

Knee ligament Mx

A

RICE
Arthroscopy
Knee brace and crutches

196
Q

What is the unhappy triad?

A

ACL, Medial meniscus, Medial collateral

197
Q

Cause of Achilles tendon rupture?

A

Sudden plantar flexion with forced dorsi flexion

Occurs intermittently active individuals

198
Q

Clinical features of Achilles tendon rupture?

A

Loud pop
Feel of being kicked back of legs
Simmons test negative

199
Q

Mx Achilles tendon rupture?

A

Non-op: serial casting with foot in full equinous then start stretching
Op: Tendon repair

200
Q

3 DDx Mechanical back pain

A

Disc protrusion - nucleus moves against annulus fibrosis
Disc herniation - annulus fibrosis torn and extrudes
Disc sequestration - bit of nucleus breaks off and compresses spinal n

201
Q

Clinical features mechanical back paion

A 
Acute onset severe back pain
Radiates legs and arms
Stabbing/electric shock-like
Loss deep tendon reflexes - LMNL
Short walks and changing position helps
202
Q

Ix Mechanical back pain

A

MRI
Straight leg raise - Sciatica
Neck compression test - cervical spine radiculopathy

203
Q

Mx Mechanical back pain

A

Conservative: PT, local heat, NSAIDs
Surgical: Decompression, discectomy

204
Q

Mx Malignant Spinal Cord Compression (MSCC)

A 
Contact MSCC Team
Rehab and transition home
Steroids
RTx
Decompressive surgery
205
Q

Cause of Discitis?

A

Strep Pyogenes

206
Q

Clinical Features of Discitis?

A

Back or neck pain not relieved by rest
Worse at night
Extension contracture protective posture

207
Q

Early signs of NF?

A

Diffuse redness
Swelling
Extreme tenderness

208
Q

Late signs NF?

A

Crepitus
Purple discolouration
Loss of sensation

209
Q

Cause of NF?

A

Polymicrobial
Group A strep - Pyogenes
S aureus

210
Q

Mx NF

A

ITU
Broad spectrum Abx
Extensive debridement

211
Q

Complications NF

A 
Sepsis
DIC
AKI
Severe necrosis 
Amputation
212
Q

What are Incomplete fracture in paeds?

A

Fractures where fracture line absent or doesnt cross width of bone - intact of periosteum on one side
3 Types:
Torus - Disruption of cortex on side of compressive force (presents as bulge) - cast/splint

Greenstick - Disruption of cortex on side tension, intact on side on compression - cast or reduce

Bowing - No disruption of cortex but angulation

MD Finals (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions