Ortho

Question 1

Monteggia v. Galeazzi Frax

Answer 1

MUGR (mugger - monteggia ulnar frax - galeazzi radial frax)

Galeazzi Fracture (radial broken, ulnar dislocated)
-Mechanism: FOOSH or blow to forearm 

Monteggia Fracture (ulnar broken, radial dislocated)

Question 2

Lateral v. Medial Epicondylitis

Answer 2

Lateral epicondylitis - tennis elbow, pain with extension movements

Medial epicondylitis - pain with pronation and flexion movements

Question 3

Lunate v. Perilunate Dislocations

Answer 3

Lunate dislocation - lunate displaced to volar aspect (can affect median nerve), looks like spilled tea cup

Peri-lunate Dislocation - dorsal displacement of capitate

Tx for both = ortho consult for open reduction and fixation

Question 4

Terry Thomas Sign

Answer 4

widening of the space between scaphoid and lunate

seen in scapholunate dislocation

Question 5

Thompson Sign

Answer 5

Squeeze calf muscle and foot does NOT plantar flex

Achilles tendon rupture

Question 6

How do you treat Achilles tendon rupture?

Answer 6

Splint in PLANTAR flexion

Question 7

If you see widened ankle mortisse what should you think of?

Answer 7

proximal fibula fracture (Maisonneuve) - associated with peroneal nerve injury (foot drop, 1st and 2nd toe sensation)

Question 8

Jones v Pseudojones Frax

Answer 8

Jones - transverse frax of 5th metatarsal shaft - WORSE, need splint

Pseudo Jones (dancer’s) - avulsion frax of 5th metarsal, walking boot (“can dance out of your ED in boot”)

Question 9

Lis Franc Frax (presentation, dx, tx)

Answer 9

Widening of space between medial cuneiform and 2nd metatarsal

PE = midfoot instability, plantar bruising

Dx = STRESS films show midfoot widening

Tx =URGENT ORTHO

Question 10

How long do you have to relocate a hip?

Answer 10

6 hrs

Question 11

Indication for CT angio in knee dislocation

Answer 11

ABI < .9

Question 12

What injury is associated with tibial plateau frax?

Answer 12

deep peroneal nerve damage

sensation to first dorsal web space, foot dorsiflexion

Question 13

Elbow Frax in Kids v. Adults

Xray Findings (2)

Answer 13

Kids - supracondylar

Adults - radial head

Xray findings: any posterior fat pad, sail sign (elevated anterior fat pad)

Question 14

Mallet Finger v. Boutonniere Injury

Answer 14

Mallet finger - flex at DIP,

Boutonniere - flex at PIP

Both treated with splint in extension

Question 15

Kanavel’s Signs (4)

Answer 15

FLEXOR TENOSYNOVITIS

Sausage-like finger
Held in flexion
Pain with passive extension
Tenderness along plantar tendon sheath

Question 16

Clavicle Frax Red Flags (3)

Answer 16

Skin Tenting

Comminuted

Depressed fracture - pointing downward

**ALL NEED ORTHO F/U

Question 17

Postvoid Residual in Cauda Equina

Answer 17

> 100-150 cc

Question 18

Rolando v. Bennett Frax

Answer 18

Rolando (WORSE) -
Metacarpal base - comminuted, intra-articular, Y-shaped

Bennett
Simple fracture at base of 1st MCP, intra-articular

Question 19

Xray Findings in Gout, Pseudogout v. OA

Answer 19

Gout - rat bite deformity

Pseudogout - chondrocalcinosis

OA - joint space narrowing, osteophytes, subchondral cysts

Question 20

Transient Tenosynovitis v. Septic Joint in Peds

Answer 20

In tenosynovitis … fever less likely, irritability less likely, can bear weight and move joint

Question 21

Colles v. Smith Frax

Answer 21

Colles - fall on extended wrist, distal radius is displaced dorsally, dinner fork appearance

Smith -fall on flexed wrist, distal radius displaced volarly, garden spade deformity