Ortho AIIMS 2017

Question 1

MC artery injury in SCH #

Answer 1

Brachial artery

Question 2

MC complication d/t SCH #

Answer 2

Malunion (Gunstock deformity/ cubitus varus)

Question 3

Complications of SCH#

Answer 3

Malunion
Volkmann’s ischemic contracture
Myositis ossificans

Question 4

Volkmann’s ischemic contracture occurs d/t

Answer 4

SCH#
Vessel: Brachial artery
Flexor policis longus and FDP (medial half) affected

Question 5

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 #

Answer 5

1. Axillary
2. Brachial
3. Femoral A
4. Axillary
5. Ant Interosseous A
6. Subclavian
7. Presacral and internal iliac
8. Femoral

Question 6

Galeazzi #

Answer 6

Distal Radio ulnar joint dislocation
Distal radial shaft #

MC than Colle’s #

Question 7

Triangular Fibrocartilage Complex (TFCC) consists of

Answer 7

Articular disc
Dorsal radioulnar ligament
Palmar radioulnar ligament
Meniscus homologue
Ulnar collateral lig
Sheath of extensor carpi ulnaris

Question 8

Primary stabilizer of distal radioulnar joint

Answer 8

Palmar and Dorsal radioulnar ligament

Question 9

Colle’s #

Answer 9

Extraarticular # of distal radius +
Dorsal angulation of distal bone fragment

Question 10

Monteggia # dislocation

Answer 10

Shaft of ulna # + Prox radioulnar joint dislocation

Question 11

Barton’s #

Answer 11

Intraarticular # distal radius
It can dorsal or volar (reverse Barton)

Question 12

Rolando #

Answer 12

Base of first metacarpal
Communited intraarticular
T or Y shape

Question 13

Smith’s #

Answer 13

Reverse Colles
Distal radius #- extraarticular
ventral/ palmar displacement of fragment

Question 14

Chauffer’s #

Answer 14

AKA Hutchinson #
# of radial stylod

Question 15

Essex lopresti lesion

Answer 15

Radial head #
Disruption of interosseous membrane and Distal radial ulnar joint ligament

Question 16

Nightstick #

Answer 16

Isolated # of radial or ulnar bone

Question 17

Management for-
1. Undisplaced patellar #
2. Displaced patellar #
3. Severely communited #

Answer 17

1. Cylinder cast
2. Tension band wire
3. Patellectomy

Question 18

Tension band wiring is done in

Answer 18

1. # patella
2. # oleacranon (with cancellous screw fixation)
3. # lateral malleolus
4. # Greater trochanter

Question 19

Neer classification involves 4 segments in injuries

Answer 19

1. Head of humerus
2. Greater tuberosity
3. Lesser tuberosity
4. Shaft of humerus

Question 20

Schatzker classification is done for

Answer 20

Tibial plateau #

Question 21

Ideberg classification

Answer 21

intraarticular glenoid fossa #

Question 22

Gartland classification

Answer 22

supracondylar # H

Question 23

Scaphoid # occurs in ___
Tenderness occurs in ___

Answer 23

fall on dorsiflexed hand
Anatomical snuff box

Question 24

Gustillo Anderson classification

Answer 24

I- < 1cm
II- 1-10 cm
IIIa- > 10 cm, contaminated, open #
IIIb- > 10 cm, open #, periosteal stripping
IIIc- > 10cm, open #, vascular injury

Question 25

Management of # acc to Gustilo anderson classification

Answer 25

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

Question 26

Non traumatic causes of AVN

Answer 26

Corticosteroids Immunosuppresants Alcohol Cytotoxic drugs Caisson's d/s Sickle cell d/s Radiation therapy Hyperlipidemia Gaucher's d/s Lupus erythematosis

Question 27

IOC for AVN

Answer 27

MRI (especially in early disease)

Question 28

Management of AVN is done by

Answer 28

Ficat and Arlet classification

Question 29

Ficat and Arlet classification

Answer 29

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

Question 30

TB hip findings

Answer 30

Periarticular osteoporosis Hazy irregular joint margins Wandering acetabulum

Question 31

Osteochondromas mostly seen in ____ which appear as____. MC sites are ____

Answer 31

Adolescents bony mass in form of stalk with cartilagenous cap. Distal femur, proximal tibia, prox humerus They are painless, benign

Question 32

Common sites of AVN

Answer 32

neck of femur (head avn) Neck of talus # (body avn) Waist of scaphoid # (prox part avn) Head of humerus Capitulum

Question 33

Named signs associated with AVN

Answer 33

1. Crescent sign 2. Hawkin's sign- subchondral lucency of dome of talus-- indicates blood supply is adequate and AVN chances are low

Question 34

Sprengel deformity

Answer 34

Congenital elevation of scapula. MC congenital shoulder deformity Scapula is small, too high, restricted movements

Question 35

Sprengel deformity is asso with

Answer 35

Klippel feil syndrome Congenital scoliosis, Kyphosis Diastematomyelia (congenital splitting of SC) Torticollis Spina bifida Underdevelopment of clavicle or humerus

Question 36

Conditions asso with Klippel Feil Syndrome

Answer 36

Scoliosis (MC) Resp anomalies CVS abnormalities (VSD MC) Renal anomalies Deafness Sprengel deformity

Question 37

Initial symptom of compartment syndrome

Answer 37

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

Question 38

MC site of compartment syndrome

Answer 38

Tibial diaphyseal fractures

Question 39

Crush syndrome occurs due to

Answer 39

Prolonged external compression--> on relief--> reperfusion injury--> myoglobinuria (causing renal tubular necrosis), systemic coagulopathy

Question 40

Features of crush syndrome

Answer 40

Red, pulseless, swollen, blistered limb Impaired renal function, metabolic acidosis, hyperkalemia, hypocalcemia

Question 41

Management of crush syndrome

Answer 41

High urine output Hemofiltration Radical excision of dead muscles Alkalization of urine

Question 42

Posterior cruciate ligament is - extrasynovial, extra-articular - extrasynovial, intra articular - intrasynovial, extraarticular - intrasynovial, intraarticular

Answer 42

extrasynovial, intra articular

Question 43

Major function of posterior cruciate ligament

Answer 43

prevents posterior translation of knee

Question 44

Other functions of post cruciate ligaments

Answer 44

Prevents internal rotation of tibia on femur when varus stress + on knee, secondary restraint to valgus, varus, ext rotation