Ortho Flashcards
What nerve is at risk during a hip replacement and what would this result in?
Sciatic nerve
Foot drop
Causes of venous ulcers
Venous HTN secondary to chronic venous insufficiency
Calf muscle pump dysfunction
Neurological disorders
Features of venous insufficiency
Oedema
Brown pigmentation
Lipadermatosclerosis
Eczema
Where do you get venous ulcers?
Above the ankle
Do you get pain in venous ulcers?
Painless
What is deep venous insufficiency related to?
Previous DVT
What is superficial venous insufficiency related to?
Varicose veins
What does doppler USS look at?
Presence of reflux
What does duplex USS look at?
Anatomy / flow of the vein
Management of venous ulcer
4 layer compression banding after exclusion of arterial disease
Surgery
When may skin grafting be needed for a venous ulcer?
Fail to heal after 12 weeks
> 10cm2
What is a majolins ulcer?
SCC
Where does majolins ulcer occur?
At sites of chronic inflammation e.g. burns, osteomyelitis after 10 - 20 years
Where do majolins ulcers mainly occur?
Lower limb
Where do arterial ulcers occur?
Toe
Heel
Are arterial ulcers painful?
Yes
What may there be areas of in arterial ulcers?
Gangrene
Features of arterial ulcers
Painful
Cold with no palpable pulses
Low ABPI measurements
Where do you commonly get neuropathic ulcers?
Plantar surface of metatarsal head
Plantar surface of hallux
What are neuropathic ulcers due to?
Pressure
What is pyoderma gangrenosum related to?
IBD / RA
Where can pyoderma gangrenosum occur at?
Stoma sites
Presentation of pyoderma gangrenosum
Erythematous nodules or pustules which can ulcerate
For total replacement of hip, what do NICE recommend in respect to LWMH?
Should be initiated 6 - 12 hours after surgery
