ortho

Question 1

4th 5th fingers in flexed position at rest

inability to extend fingerst at interphlangeal joint

Dx?

Answer 1

claw hand

ulnar nerve damage

Question 2

inability to oppose thumb

thumb on the same plane as other fingers at rest

Answer 2

ape hand

median nerve damage

Question 3

a patient trie to make a fist but cannot flex 2nd, 3rd fingers.

2nd and 3rd fingers stay extended.

cannot oppose thum

Answer 3

hand of benediction

median nerve damage

Question 4

wrist drop

what nerve damage?

Answer 4

radial nerve damage

Question 5

painful thickened fascia of the 4th finger and palm

Dx? Tx?

Answer 5

Dupuytren’s contracture

collagenase injection

surgery (open fasciectomy)

Question 6

Pain in the knee

Swelling

A popping sensation during the injury

Difficulty bending and straightening the leg

A tendency for your knee to get “stuck” or lock up

suspect menicus injury. what is the higly sensitive and specific physical examination?

Answer 6

Thessaly test.

Question 7

the most commonly injured nerve by mid-shaft humerus fractures?

Answer 7

radial nerve

Question 8

40 yo woman with a Hx of burining pain between third and fourth metatarsal aheads.

The pain gets worse on weight bearing on hard surface and relieved by talking off the shoe and squeesing the forefoot.

localized tenderness between the metatarsal heads.

Answer 8

Morton Neuroma

Question 10

pain and feeling weakness of medial ankle and foot

the pain is aggravated by standing and walking

staing on toes aggravates the pain

Answer 10

tibialis posterior tendinopathy

Question 11

thumb pain, gets worse with thumb and writs movements, feels like a dull ache.

tenderness noticed on palpation over and just proximal to the radial syloid.

Which test to aid the diagnosis?

diagnosis?

Tx?

Answer 11

Finkelstein’s test : holds the thumb in palm with fingers and deviate the wrist to ulnar side.

De Quervain tenosynositis

Steroid injection

Question 12

mid-shaft humerus fracture.

complication? m/c nerve injury? findgins?

Answer 12

radial verve injury

inability to extent the thumb, wrist drop

Question 13

Colles fracture

the earliest complication?

the most common complication?

Answer 13

• the earliest complication : Volkmann ischemic contracture
• the most common complication : malunion

Question 14

nerve innvervation of arm muscles

flexor : biceps, brachialis, coracobrachialis

extensors : triceps,

Answer 14

flexor : by musculocutaneous n

extensors : radial n.

Question 15

open fracture, Management? (in right order)

Answer 15

1. wound clean (gross contamination)
2. take a photo
3. dress with sterile wet cover
4. IV analgesics,
5. Reduction by gentle traction
6. IV antibiotics
7. tetanus prophylaxis if necessary
8. surgical wound debridement in OR.

Question 16

the most common complication of scaphoid fracture?

Answer 16

avascular necrosis

Question 17

12 yrs, tibial tubercle pain, tenderness,

pain reproduced when straitening flexed knee

widening of apophysis and fragmetatio of bones

Dx?

Tx?

Px?

Answer 17

Osgood - Schlatter disease

self limiting in up to 12 months

Question 18

Mallet finger.

what is damaged and what movement is limited?

Answer 18

Question 19

frozen shoulder

adhesive capsulitis

sever pain

Tx?

Answer 19

prednisolone 30mg daily for three weeks and slowly taper.

Question 20

Ottawa knee rules

a knee x-ray is required when a child is present with..what conditions?

Answer 20

1. isolated patellar tenderness.
2. tenderness at the head of the fibula
3. inability to flex at 90%
4. inability to bear weight immediately after trauma and in an emergency.

Question 21

Pathophysiology? Tx?

• Transient synovitis of hip
• Legg-Calves-Perthes
• slipped capital femoral epiphsysis
• Osgood-Schlatter

Answer 21

• Transient synovitis of hip : age 4-10, no bony change, conservative Tx.
• Legg-Calves-Perthes: age 4-8, avascular necrosis of the capital femoral epiphysis, conservative Tx
• slipped capital femoral epiphsysis : age 10-15, overweight, displacement of femoral neck, surgical Tx
• Osgood-Schlatter : osteochondritis of the tibial tubercle.