Ortho high yield

Question 1

Pathophysiology behind a buckle fracture

Answer 1

The junction between the metaphysis and diaphysis is more vascular and porous in kids. It is a weak spot.

Question 2

Muscles that attach at the pes anserinus

Answer 2

SGT FOT Sartorious, Gracilis, Semitendiosus muscles innervated by Femoral, Obturator, and Tibial nerve respectively.

Question 3

Name the Lateral tubercle of the tibia and what attaches to it.

Answer 3

Gerdy’s tubercle, IT band inserts into it.

Question 4

What is the proximal muscle that is retracted during plating of a distal radius fracture?

Answer 4

Pronator muscle

Question 5

Supinators of the wrist?

Answer 5

Biceps muscle, brachioradialis, supinator

Question 6

Terry Thomas sign

Answer 6

An increase in the scapholunate space on an AP radiograph of the wrist (or coronal CT). The increased distance indicates scapholunate dissociation (often with rotary subluxation of the scaphoid) due to ligamentous injury. There is no consensus as to what measurement constitutes widening, but a cut-off of 3 or 4 mm is reasonable in most cases.

Question 7

What are the layers of the growth plate?

Answer 7

reserve zone, proliferative zone, hypertrophic zone, zone of provisional calcification

Question 8

What layer does the Salter Harris fracture occur?

Answer 8

Zone of Hypertrophy

Question 9

What is the Tip to Apex distance?

Answer 9

The sum of the distance from the tip of the lag screw to the apex of the femoral head on the AP and lateral X-rays. (measured in mm) baumgartner paper

Question 10

Why wait for EMG study after nerve injury?

Answer 10

Mullerian degeneration must occur first. This can take 4-6 weeks.

Question 11

What is a Fabella

Answer 11

Ossification in the popliteal fossa

Question 12

SALTER Harris mnemonic

Answer 12

S-Slip through plate Type I A-Above epiphysis Type II L-Lower (below epiphysis) Type III TE-Through Everything Type IV R- Rammed (crushed) Type V

Question 13

Complication of radial head Fracture?

Answer 13

Restricted motion

Question 14

What is the distal radius colles fracture classification?

Answer 14

Frykman Classification

Question 15

Frykman classification types?

Answer 15

type I : transverse metaphyseal fracture. This includes both a Colles and Smith fracture as angulation is not a feature type II : type I + ulnar styloid fracture type III : fracture involves the radiocarpal joint. This includes both a Barton and reverse Barton fractures. type IV : type III + ulnar styloid fracture type V : transverse fracture involves distal radioulnar joint type VI : type V + ulnar styloid fracture type VII : comminuted fracture with involvement of both the radiocarpal and radioulnar joints type VIII : type VII + ulnar styloid fracture

Question 16

Septic joint lab values

Answer 16

CRP>5 ESR>30 (this stays elevated longer than CRP) WBC>10 LDH>250 (sensitive for infection)

Question 17

What to do for open fracture?

Answer 17

1. Trauma survey 2. Early IV antibiotics and tetanus shot 3. direct pressure to control bleeding 4. assess soft tissue damage and neuromuscular exam 5. Move gross debris, place sterile saline soaked dressing on site. 6. Stabilize with splint 7. Surgery with low pressure lavage

Question 18

What is the Intra capsular Hip fracture classification system?

Answer 18

Garden Classification

Question 19

Garden classification type I

Answer 19

I-Incomplete or impacted bone injury w/ valgus angulation of distal component.

Question 20

What makes an intertrochanteric fracture stable?

Answer 20

Intertrochanteric fx is stable when the posteromedial cortex remains intact or has minimal comminution making it possible to obtain and maintain a stable reduction.

Question 21

What makes an intertrochanteric fracture unstable?

Answer 21

Greater comminution of posteromedial cortex Reverse obliquity pattern is unstable b/c of the tendency for medial displacement of femoral shaft (fx extends from medial cortex proximally to lateral cortex distally)

Question 22

What is a Torus (buckle) fracture?

Answer 22

Concave cortex compresses (buckles), convex/tension side: intact

Question 23

What is a greenstick fracture?

Answer 23

Convex/tension side fracture/plastic deformity, concave cortex intact–(reduce if >10 degrees of angulation).

Question 24

6 lines of pelvis

Answer 24

iliopectineal ilioischial teardrop roof (dome) Ant. Wall Post Wall

Question 25

Normal measurements for the wrist

Answer 25

• 23(22) degrees of radial inclination - 11 mm radial height - 11 degrees of volar tilt

Question 26

Smith Fracture

Answer 26

Volar displacement (apex dorsal)

Question 27

Barton Fracture

Answer 27

fx/dislocation of wrist in which dorsal or volar rim of distal radius is displaced with hand and carpus. Volar is more common.

Question 28

Chauffeur fracture

Answer 28

Radial styloid fracture

Question 29

Monteggia Fracture

Answer 29

Fracture of the proximal ulna accompanied by radial head dislocation classification–Bado (anterior angulation and dislocation most common)

Question 30

Monteggia Fracture Bado Classification types

Answer 30

1. Ant dislocation of radial head w/ fx of ulnar diaphysis at any level w/ anterior angulation
2. Post dislocation of radial head w/ fx of ulnar diaphysis w/ posterior angulation.
3. Lateral dislocation of radial head w/ fx of ulnar metaphysis
4. Galeazzi/Piedmont Fracture

Question 31

Galeazzi/Piedmont Fracture

Answer 31

Fracture of the radial diaphysis at the junction of the middle and distal 1/3 with disruption of the DRUJ “A fracture of necessity” because it requires ORIF to achieve a good result Classification- by mechanism

Question 32

Galeazzi/Piedmont classification types

Answer 32

Pronation-Galeazzi-FOOSH with forearm pronation. Direct trauma to the dorsolateral aspect of the wrist. Supination-Reverse Galeazzi-FOOSH with forearm supination. ULNA shaft fx with DRUJ dislocation

Question 33

olecranon fracture Classification

Answer 33

Colton classification undisplaced:

Question 34

Name the Supracondylar humerus Fx classification system

Answer 34

Gartland classification Extension (95%) vs Flexion

Question 35

Compartments of Forearm

Answer 35

3 in total -volar - most commonly affected - dorsal - mobile wad (lateral) rarely involved, muscles - brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis

Question 36

Hand compartments

Answer 36

10 in total hypothenar thenar adductor pollicis dorsal interosseous (x4) volar (palmar) interosseous (x3)

Question 37

Radial Head Fx classification

Answer 37

Mason Classification I: minimally displaced fx, no mechanical block to rotation, II: marginal fractures with displacement (impact ion, depression, angulation), possible mechanical block to forearm rotation III:comminuted and displaced fx involving entire head, mechanical block to motion IV: (Hotchkiss modification) radial head fx with elbow dislocation.

Question 38

Extensor compartments of wrist

Answer 38

I EPB, APL II ECRB, ECRL III EPL IV E Digitorum, E Indicis V E digiti minimi VI ECU

Question 39

Boundaries of shoulder quadrangular space

Answer 39

Teres minor, major, long head of triceps and humerus.

Question 40

What structure(s) pass through quadrangular space of shoulder

Answer 40

posterior humeral circumflex artery, Axillary nerve.

Question 41

What are borders of triangular interval

Answer 41

Teres major, long and lateral heads of triceps

Question 42

What structure(s) pass through triangular interval

Answer 42

Radial nerve, deep brachial artery

Question 43

What is neer classification

Answer 43

Classification of prox humerus fx. # of parts: greater tub, lesser tub, shaft, head. Parts displaced >1cm or 45 degrees angulation.

Question 44

supracondylar humerus fracture classifcation

Answer 44

Gartland classification