ortho worksheets Flashcards
Describe the three stages of bone healing
haematoma : blood infiltrates 2 weeks
soft callus: after 2 weeks till 6 weeks
hard callus
factors that slow down bone healing
smoking
interruption of blood flow eg macrovascular damage PAD,
NSAIDs
physio’s role in recovery after injury
- improving independence and getting motility back=elderly
- getting range of movement back in young and elderly
social ramifications of fractures
-young
-dominant head
-occupation
-loss of indepdence
-length of recovery spent immobilied
surgery versus conservative
surgery versus conservative
- conservative need longer bed rest so if need to get back to work
- surgery have the risks
distal radius fracture dorsal treatment
cast closed reduction
but if slips in cast then ORIF
complications of distal radius fracture
mal-union in the wrist so reduced mobility
3 types of nerve damage
neuropraxia: no axonal discontinuty, need to release pressure
- axontemesis: break in axon
- neurotemesis: break in nerve
what nerve risks damage in distal radius fracture and what is this called
median nerve in carpal tunnel
-thenar eminence often spared as palmar cutaneous branch
how to treat median nerve compromise
emergency reduction in ED
2 types of wrist fractures that require operative intervention
volar translated
scaphoid risk of AVN
4 watershed areas fracture
scaphoid
talus
NOF
head of humerus
NOF # treatment for very elderly elderlyish young if displaced intracapsular
v.elderly=hemi
elderly=totalhr
young=cannulated hip screw
treatment intertrochanteric #
dynamic hip screw
treatment undisplaced intracapsular nof #
cannulated hip screw
subtrochanteric # treatment
intermedullary nailing
2 classifications for ankle fractures
weber or salter harris
weber ankle classification and meaning
always on the fibula
A=inferior to the syndesmosis, more stable, reduction/cast
B=at the level of the syndesmosis, depends stability, may require ORIF, possible medial fracture
C= superior to synesmosis, not stable, talar shift with usual medial malleous fracture need ORIF
4 signs of OA on an x-ray
osteophytes
subchondral cysts
subchondral sclerosis
joint space narrowing
what are the 3# of the 5th metatarsal and which is the watershed
avulsion# proximal
jones# =watershed area
mid-shaft#
test for an achilles rupture
thomspon test- lie down and squeeze gastrocnemius and normally plantar flex the foot
2 clinical findings of chronic carpal tunnel compression
wasting of the thenar eminence and
abductor pollicis brevis
common causes of carpal tunnel
pregnancy obesity endocrine: fluid retain hypothyroid acromegaly poor DM rheumatoid a synovitis
what has to be divided for carpal tunnel syndrome
flexor retinalculum