Ortho AIIMS 2017 Flashcards
MC artery injury in SCH #
Brachial artery
MC complication d/t SCH #
Malunion (Gunstock deformity/ cubitus varus)
Complications of SCH#
Malunion
Volkmann’s ischemic contracture
Myositis ossificans
Volkmann’s ischemic contracture occurs d/t
SCH#
Vessel: Brachial artery
Flexor policis longus and FDP (medial half) affected
Vessel involved in
1. Shoulder dislocation
2. Posterior dislocation of elbow
3. Hip dislocation
4. Prox. humeral #
5. Both forearm bone #
6. 1st rib #
7. Pelvic #
8. Femur #
- Axillary
- Brachial
- Femoral A
- Axillary
- Ant Interosseous A
- Subclavian
- Presacral and internal iliac
- Femoral
Galeazzi #
Distal Radio ulnar joint dislocation
Distal radial shaft #
MC than Colle’s #
Triangular Fibrocartilage Complex (TFCC) consists of
Articular disc
Dorsal radioulnar ligament
Palmar radioulnar ligament
Meniscus homologue
Ulnar collateral lig
Sheath of extensor carpi ulnaris
Primary stabilizer of distal radioulnar joint
Palmar and Dorsal radioulnar ligament
Colle’s #
Extraarticular # of distal radius +
Dorsal angulation of distal bone fragment
Monteggia # dislocation
Shaft of ulna # + Prox radioulnar joint dislocation
Barton’s #
Intraarticular # distal radius
It can dorsal or volar (reverse Barton)
Rolando #
Base of first metacarpal
Communited intraarticular
T or Y shape
Smith’s #
Reverse Colles
Distal radius #- extraarticular
ventral/ palmar displacement of fragment
Chauffer’s #
AKA Hutchinson #
# of radial stylod
Essex lopresti lesion
Radial head #
Disruption of interosseous membrane and Distal radial ulnar joint ligament
Nightstick #
Isolated # of radial or ulnar bone
Management for-
1. Undisplaced patellar #
2. Displaced patellar #
3. Severely communited #
- Cylinder cast
- Tension band wire
- Patellectomy
Tension band wiring is done in
- # patella
- # oleacranon (with cancellous screw fixation)
- # lateral malleolus
- # Greater trochanter
Neer classification involves 4 segments in injuries
- Head of humerus
- Greater tuberosity
- Lesser tuberosity
- Shaft of humerus
Schatzker classification is done for
Tibial plateau #
Ideberg classification
intraarticular glenoid fossa #
Gartland classification
supracondylar # H
Scaphoid # occurs in ___
Tenderness occurs in ___
fall on dorsiflexed hand
Anatomical snuff box
Gustillo Anderson classification
I- < 1cm
II- 1-10 cm
IIIa- > 10 cm, contaminated, open #
IIIb- > 10 cm, open #, periosteal stripping
IIIc- > 10cm, open #, vascular injury
Management of # acc to Gustilo anderson classification
Grade I- debridement, CRIF
Grade II, IIIa- if < 6hrs same as gr 1, if > 6 hrs same as gr IIIb and IIIc
Grade IIIb, IIIc- Debridment, external fixation
Non traumatic causes of AVN
Corticosteroids
Immunosuppresants
Alcohol
Cytotoxic drugs
Caisson’s d/s
Sickle cell d/s
Radiation therapy
Hyperlipidemia
Gaucher’s d/s
Lupus erythematosis
IOC for AVN
MRI (especially in early disease)
Management of AVN is done by
Ficat and Arlet classification
Ficat and Arlet classification
1- X ray N, MRI + – Mx: bisphosphonates
2a- Xray sclerosis, cysts, no collapse– Mx: Bisphosphonates
2b- X ray crescent sign, no collapse– Mx: Surgical decompression
3- Collapse, loss of sphericity– Mx: Osteotomy
4- Advanced arthritis– Mx: THR
TB hip findings
Periarticular osteoporosis
Hazy irregular joint margins
Wandering acetabulum
Osteochondromas mostly seen in ____ which appear as____. MC sites are ____
Adolescents
bony mass in form of stalk with cartilagenous cap. Distal femur, proximal tibia, prox humerus
They are painless, benign
Common sites of AVN
neck of femur (head avn)
Neck of talus # (body avn)
Waist of scaphoid # (prox part avn)
Head of humerus
Capitulum
Named signs associated with AVN
- Crescent sign
- Hawkin’s sign- subchondral lucency of dome of talus– indicates blood supply is adequate and AVN chances are low
Sprengel deformity
Congenital elevation of scapula. MC congenital
shoulder deformity
Scapula is small, too high, restricted movements
Sprengel deformity is asso with
Klippel feil syndrome
Congenital scoliosis, Kyphosis
Diastematomyelia (congenital splitting of SC)
Torticollis
Spina bifida
Underdevelopment of clavicle or humerus
Conditions asso with Klippel Feil Syndrome
Scoliosis (MC)
Resp anomalies
CVS abnormalities (VSD MC)
Renal anomalies
Deafness
Sprengel deformity
Initial symptom of compartment syndrome
Pain (out of proportion, on passive stretching of fingers)
Later comes pallor, paraesthesia, pulselessness, paralysis
So if there is decreased response to analgesia after POP cast suspect compartment syndrome
MC site of compartment syndrome
Tibial diaphyseal fractures
Crush syndrome occurs due to
Prolonged external compression–> on relief–> reperfusion injury–> myoglobinuria (causing renal tubular necrosis), systemic coagulopathy
Features of crush syndrome
Red, pulseless, swollen, blistered limb
Impaired renal function, metabolic acidosis, hyperkalemia, hypocalcemia
Management of crush syndrome
High urine output
Hemofiltration
Radical excision of dead muscles
Alkalization of urine
Posterior cruciate ligament is
- extrasynovial, extra-articular
- extrasynovial, intra articular
- intrasynovial, extraarticular
- intrasynovial, intraarticular
extrasynovial, intra articular
Major function of posterior cruciate ligament
prevents posterior translation of knee
Other functions of post cruciate ligaments
Prevents internal rotation of tibia on femur when varus stress + on knee,
secondary restraint to valgus, varus, ext rotation
