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Rapid Review > Ortho Recall > Flashcards

Ortho Recall Flashcards

1
Q

WBAT

A

Weight bearing as tolerated

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2
Q

Unstable fracture or

dislocation

A

Fracture or dislocation in which further
deformation will occur if reduction is not
performed

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3
Q

Varus

A 
Extremity abnormality with apex of
defect pointed away from midline
(e.g., genu varum  bowlegged; with
valgus, this term can also be used to
describe fracture displacement)
(Think: knees are very varied apart)
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4
Q

Valgus

A

Extremity abnormality with apex of
defect pointed toward the midline
(e.g., genu valgus knock-kneed)

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5
Q

Dislocation

A

Total loss of congruity and contact

between articular surfaces of a joint

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6
Q

Subluxation

A

Loss of congruity between articular
surfaces of a joint; articular contact still
remains

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7
Q

Arthroplasty

A

Total joint replacement (most last 10 to

15 years)

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8
Q

Arthrodesis

A

Joint fusion with removal of articular

surfaces

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9
Q

Osteotomy

A 
Cutting bone (usually wedge resection) to
help realigning of joint surfaces
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10
Q

Non-union

A

Failure of fractured bone ends to fuse

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11
Q

Diaphysis

A

Main shaft of long bone

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12
Q

Metaphysis

A

Flared end of long bone

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13
Q

Physis

A

Growth plate, found only in immature

bone

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14
Q

Define extremity
examination in fractured
extremities.

A
  1. Observe entire extremity (e.g., open,
    angulation, joint disruption)
  2. Neurologic (sensation, movement)
  3. Vascular (e.g., pulses, cap refill)
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15
Q

Which x-rays should be

obtained? (trauma)

A 
Two views (also joint above and below
fracture)
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16
Q

How are fractures

described?

A
  1. Skin status (open or closed)
  2. Bone (by thirds: proximal/middle/
    distal)
  3. Pattern of fracture (e.g., comminuted)
  4. Alignment (displacement, angulation,
    rotation)
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17
Q

How do you define the
degree of angulation,
displacement, or both?

A

Define lateral/medial/anterior/posterior
displacement and angulation of the distal
fragment(s) in relation to the proximal
bone

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18
Q

Closed fracture

A

Intact skin over fracture/hematoma

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19
Q

Open fracture

A

Wound overlying fracture, through which
fracture fragments are in continuity with
outside environment; high risk of infection
(Note: Called “compound fracture” in
the past)

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20
Q

Simple fracture

A

One fracture line, two bone fragments

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21
Q

Comminuted fracture

A

Results in more than two bone fragments;

a.k.a. fragmentation

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22
Q

Segmental fracture

A

Two complete fractures with a “segment”

in between

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23
Q

Transverse fracture

A

Fracture line perpendicular to long axis

of bone

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24
Q

Oblique fracture

A

Fracture line creates an oblique angle

with long axis of bone

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25
Q

Spiral fracture

A

Severe oblique fracture in which fracture
plane rotates along the long axis of bone;
caused by a twisting injury

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26
Q

Longitudinal fracture

A

Fracture line parallel to long axis of bone

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27
Q

Impacted fracture

A

Fracture resulting from compressive force;
end of bone is driven into contiguous
metaphyseal region without displacement

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28
Q

Pathologic fracture

A

Fracture through abnormal bone (e.g.,

tumor-laden or osteoporotic bone)

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29
Q

Stress fracture

A

Fracture in normal bone from cyclic

loading on bone

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30
Q

Greenstick fracture

A

Incomplete fracture in which cortex on
only one side is disrupted; seen in
children

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31
Q

Torus fracture

A

Impaction injury in children in which
cortex is buckled but not disrupted
(a.k.a. buckle fracture)

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32
Q

Avulsion fracture

A

Fracture in which tendon is pulled from

bone, carrying with it a bone chip

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33
Q

Periarticular fracture

A

Fracture close to but not involving the joint

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34
Q

Intra-articular fracture

A 
Fracture through the articular surface of
a bone (usually requires ORIF)
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35
Q

Colles’ fracture

A

Distal radius fracture with dorsal
displacement and angulation, usually
from falling on an outstretched hand
(a common fracture!)

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36
Q

Smith’s fracture

A

“Reverse Colles’ fracture”—distal radial
fracture with volar displacement and
angulation, usually from falling on the
dorsum of the hand (uncommon)

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37
Q

Jones’ fracture

A

Fracture at the base of the fifth

metatarsal diaphysis

38
Q

Bennett’s fracture

A 
Fracture-dislocation of the base of the
first metacarpal (thumb) with disruption
of the carpometacarpal joint
39
Q

Boxer’s fracture

A

Fracture of the metacarpal neck,

“classically” of the small finger

40
Q

Nightstick fracture

A

Ulnar fracture

41
Q

Clay shoveler’s avulsion

fracture

A

Fracture of spinous process of C6–C7

42
Q

Hangman’s fracture

A

Fracture of the pedicles of C2

43
Q

Transcervical fracture

A

Fracture through the neck of the femur

44
Q

Tibial plateau fracture

A

Intra-articular fracture of the proximal tibia

the plateau is the flared proximal end

45
Q

Monteggia fracture

A

Fracture of the proximal third of the ulna

with dislocation of the radial head

46
Q

Galeazzi fracture

A

Fracture of the radius at the junction of
the middle and distal thirds accompanied
by disruption of the distal radioulnar joint

47
Q

Tibial “plateau” fracture

A

Proximal tibial fracture

48
Q

“Pilon” fracture

A

Distal tibial fracture

49
Q

Pott’s fracture

A

Fracture of distal fibula

50
Q

Pott’s disease

A

Tuberculosis of the spine

51
Q

What are the major

orthopaedic emergencies?

A
  1. Open fractures/dislocations
  2. Vascular injuries (e.g., knee
    dislocation)
  3. Compartment syndromes
  4. Neural compromise, especially spinal
    injury
  5. Osteomyelitis/septic arthritis; acute,
    i.e., when aspiration is indicated
  6. Hip dislocations—require immediate
    reduction or patient will develop avascular
    necrosis; “reduce on the x-ray table”
  7. Exsanguinating pelvic fracture (binder,
    external fixator)
52
Q

What is the main risk when

dealing with an open fracture?

A

Infection

53
Q

Which fracture has the

highest mortality

A 
Pelvic fracture (up to 50% with open
pelvic fractures)
54
Q

What factors determine the

extent of injury (3)?

A 
1. Age: suggests susceptible point in
musculoskeletal system:
Child—growth plate
Adolescent—ligaments
Elderly—metaphyseal bone
2. Direction of forces
3. Magnitude of forces
55
Q

What is the acronym for
indications for OPEN
reduction?

A 
“NO CAST”:
Nonunion
Open fracture
Compromise of blood supply
Articular surface malalignment
Salter-Harris grade III, IV fracture
Trauma patients who need early
ambulation
56
Q

Define open fractures by
Gustilo-Anderson
classification:
Grade I?

A

1-cm laceration

57
Q

Define open fractures by
Gustilo-Anderson
classification:
Grade II?

A

1 cm, minimal soft tissue damage

58
Q

Define open fractures by
Gustilo-Anderson
Grade IIIA?

A

Open fracture with massive tissue

devitalization/loss, contamination

59
Q

Define open fractures by
Gustilo-Anderson
Grade IIIB?

A

Open fracture with massive tissue
devitalization/loss and extensive
periosteal stripping, contamination,
inadequate tissue coverage

60
Q

Define open fractures by
Gustilo-Anderson
Grade IIIC?

A

Open fracture with major vascular injury

requiring repair

61
Q

What are the five steps in
the initial treatment of an
open fracture?

A 
1. Prophylactic antibiotics to include IV
gram-positive  anaerobic coverage:
Grade I—cefazolin (Ancef ®)
Grade II or III—cefoxitin/gentamicin
2. Surgical débridement
3. Inoculation against tetanus
4. Lavage wound 6 hours postincident
with high-pressure sterile irrigation
5. Open reduction of fracture and stabilization
(e.g., use of external fixation)
62
Q

What structures are at risk

with a humeral fracture?

A

Radial nerve, brachial artery

63
Q

What must be done when
both forearm bones are
broken?

A

Because precise movements are needed,
open reduction and internal fixation are
musts

64
Q

How have femoral fractures

been repaired traditionally?

A

Traction for 4 to 6 weeks

65
Q

What is the newer technique?femoral fractures

A

Intramedullary rod placement

66
Q

What are the advantages?

Intramedullary rod placement

A

Nearly immediate mobility with

decreased morbidity/mortality

67
Q

What is the chief concern

following tibial fractures?

A

Recognition of associated compartment

syndrome

68
Q

What is suggested by pain in

the anatomic snuff-box?

A

Fracture of scaphoid bone (a.k.a.

navicular fracture)`

69
Q

What is the most common
cause of a “pathologic”
fracture in adults?

A

Osteoporosis

70
Q

What is acute compartment

syndrome?

A

Increased pressure within an osteofascial
compartment that can lead to ischemic
necrosis`

71
Q

How is it diagnosed? acute compartment

syndrome?

A 
Clinically, using intracompartmental
pressures is also helpful (especially in
unresponsive patients); fasciotomy is
clearly indicated if pressure in the
compartment is 40 mm Hg (30 to
40 mm Hg is a gray area)
72
Q

acute compartment

syndrome?What are the causes?

A

Fractures, vascular compromise,
reperfusion injury, compressive dressings;
can occur after any musculoskeletal
injury

73
Q

What are common causes
of forearm compartment
syndrome?

A

Supracondylar humerus fracture, brachial
artery injury, radius/ulna fracture, crush
injury

74
Q

What is Volkmann’s

contracture?

A

Final sequela of forearm compartment
syndrome; contracture of the forearm
flexors from replacement of dead muscle
with fibrous tissue

75
Q

What is the most common
site of compartment
syndrome?

A

Calf (four compartments: anterior,
lateral, deep posterior, superficial
posterior compartments)

76
Q 
What situations should
immediately alert one to be
on the lookout for a
developing compartment
syndrome (4)?
A 
1. Supracondylar elbow fractures in
children
2. Proximal/midshaft tibial fractures
3. Electrical burns
4. Arterial/venous disruption
77
Q

What are the symptoms of

compartment syndrome?

A

Pain, paresthesias, paralysis

78
Q

What are the signs of

compartment syndrome?

A

Pain on passive movement (out of
proportion to injury), cyanosis or pallor,
hypoesthesia (decreased sensation,
decreased two point discrimination), firm
compartment

79
Q

Can a patient have a
compartment syndrome
with a palpable or Dopplerdetectable
distal pulse?

A

YES!

80
Q

What are the possible
complications of
compartment syndrome?

A

Muscle necrosis, nerve damage,

contractures, myoglobinuria

81
Q

What is the initial treatment
of the orthopaedic patient
developing compartment
syndrome?

A

Bivalve and split casts, remove
constricting clothes/dressings, place
extremity at heart level

82
Q

What is the definitive
treatment of compartment
syndrome?

A

Fasciotomy within 4 hours (6–8 hours
maximum) if at all possible
MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS

83
Q 
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Radial
A

Wrist extension; dorsal web space;

sensation: between thumb and index finger

84
Q

Name the motor and
sensation tests used to assess
the following peripheral
nerves:Ulnar

A

Little finger abduction; sensation: little

finger-distal ulnar aspect

85
Q

Name the motor and
sensation tests used to assess
the following peripheral
nerves:Median

A

Thumb opposition or thumb pinch

sensation: index finger-distal radial aspect

86
Q

Name the motor and
sensation tests used to assess
the following peripheral
nervesAxillary

A

Arm abduction; sensation: deltoid patch

on lateral aspect of upper arm

87
Q

Name the motor and
sensation tests used to assess
the following peripheral
nerves:Musculocutaneous

A

Elbow (biceps) flexion; lateral forearm

sensation

88
Q

How is a peripheral nerve

injury treated?

A

Controversial, although clean lacerations
may be repaired primarily; most injuries
are followed for 6 to 8 weeks (EMG)

89
Q

What fracture is associated

with a calcaneus fracture?

A

L-spine fracture (usually from a fall)

90
Q

Name the nerves of the

brachial plexus.

A

Think: “morning rum” or “A.M. RUM”
Axillary, Median, then Radial, Ulnar, and
Musculocutaneous nerves

91
Q

What are the two indications
for operative exploration
with a peripheral nerve
injury?

A
  1. Loss of nerve function after reduction
    of fracture
  2. No EMG signs of nerve regeneration
    after 8 weeks (nerve graft)

Rapid Review (13 decks)

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