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
what is unusual about scaphoid blood supply
all comes from the end so most proximal risk of avn
3 things that block external rotation of the arm
adhesive capsulitis
posterior dislocation
glenohumeral OA
3 things that block internal rotation of the arm
rotator cuff tear
impingement
adhesive capsulitis
definition of OA
loss of articular cartilage and remodelling of subchondral bone
primary and secondary risk factors for OA
primary: age, obesity
secondary: trauma, pathology past infection
what hip muscles cause tredelenburg gait
abductor
gluteus maximus and minimus
4 operative risks of arthroplasty
nerve injuries peri prosthetic infection MI on table DVT chronic infection hip dislocation wearing needs revision
3 knee injuries that increase the risk of OA
ACL
meniscus tear
tibial plateau fractures
alternative to knee arthroplasty in young patient with knee arthritis of one knee compartment
tibial osteotomy to realign varus
what is the sterile field and where are safest places for you to observe in theatre
lamina flow
hazards in a theatre
radiation
needles
visers for splatter
purpose of WHO checklist in theatre
check for allergies prophylactic risk health conditions check consent which side
purpose of lamina flow
changes circulating flow of the air
