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Section III Subspecialty Surgery P517 > Orthopaedic Surgery, C74 P690-720 > Flashcards

Orthopaedic Surgery, C74 P690-720 Flashcards

1
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
ORIF?
P690
A

Open Reduction Internal Fixation

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2
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
ROM?
P690
A

Range Of Motion

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3
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
FROM?
P690
A

Full Range Of Motion

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4
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
ACL?
P690
A

Anterior Cruciate Ligament

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5
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
PCL?
P690
A

Posterior Cruciate Ligament

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6
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
MCL?
P690
A

Medial Collateral Ligament

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7
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
PWB?
P690
A

Partial Weight Bearing

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8
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
FWB?
P690
A

Full Weight Bearing

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9
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
WBAT?
P690
A

Weight Bearing As Tolerated

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10
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
THA?
P691
A

Total Hip Arthroplasty

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11
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
TKA?
P691
A

Total Knee Arthroplasty

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12
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
THR?
P691
A

Total Hip Replacement

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13
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
TKR?
P691
A

Total Knee Replacement

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14
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
PROM?
P691
A

Passive Range Of Motion

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15
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
AROM?
P691
A

Active Range Of Motion

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16
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
AFO?
P691
A

Ankle Foot Orthotic

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17
Q 
ORTHOPAEDIC TERMS
What do the following
abbreviations stand for:
AVN?
P691
A

AVascular Necrosis

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18
Q

ORTHOPAEDIC TERMS
Define the following terms:
Supination
P691

A

Palm up

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19
Q

ORTHOPAEDIC TERMS
Define the following terms:
Pronation
P691

A

Palm down

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20
Q

ORTHOPAEDIC TERMS
Define the following terms:
Plantarflexion
P691

A

Foot down at ankle joint (plant foot in

ground)

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21
Q

ORTHOPAEDIC TERMS
Define the following terms:
Foot dorsiflexion
P691

A

Foot up at ankle joint

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22
Q

ORTHOPAEDIC TERMS
Define the following terms:
Adduction
P691

A

Movement toward the body

ADDuction = ADD to the body

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23
Q

ORTHOPAEDIC TERMS
Define the following terms:
Abduction
P691

A

Movement away from the body

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24
Q

ORTHOPAEDIC TERMS
Define the following terms:
Inversion
P691

A

Foot sole faces midline

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25
Q

ORTHOPAEDIC TERMS
Define the following terms:
Eversion
P691

A

Foot sole faces laterally

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26
Q

ORTHOPAEDIC TERMS
Define the following terms:
Volarflexion
P691

A

Hand flexes at wrist joint toward flexor

tendons

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27
Q

ORTHOPAEDIC TERMS
Define the following terms:
Wrist dorsiflexion
P691

A

Hand flexes at wrist joint toward extensor

tendons

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28
Q

ORTHOPAEDIC TERMS
Define the following terms:
Allograft bone
P691

A

Bone from human donor other than

patient

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29
Q

ORTHOPAEDIC TERMS
Define the following terms:
Reduction
P692

A

Maneuver to restore proper alignment to

fracture or joint

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30
Q

ORTHOPAEDIC TERMS
Define the following terms:
Closed reduction
P692

A

Reduction done without surgery

e.g., casts, splints

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31
Q

ORTHOPAEDIC TERMS
Define the following terms:
Open reduction
P692

A

Surgical reduction

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32
Q

ORTHOPAEDIC TERMS
Define the following terms:
Fixation
P692

A

Stabilization of a fracture after reduction
by means of surgical placement of
hardware that can be external or internal
(e.g., pins, plates, screws)

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33
Q

ORTHOPAEDIC TERMS
Define the following terms:
Tibial pin
P692 (picture)

A

Pin placed in the tibia for treating femur
or pelvic fractures by applying skeletal
traction

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34
Q 
ORTHOPAEDIC TERMS
Define the following terms:
Unstable fracture or
dislocation
P692
A

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

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35
Q

ORTHOPAEDIC TERMS
Define the following terms:
Varus
P693 (picture)

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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36
Q

ORTHOPAEDIC TERMS
Define the following terms:
Valgus
P693 (picture)

A

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

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37
Q

ORTHOPAEDIC TERMS
Define the following terms:
Dislocation
P693

A

Total loss of congruity and contact

between articular surfaces of a joint

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38
Q

ORTHOPAEDIC TERMS
Define the following terms:
Subluxation
P693

A

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

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39
Q

ORTHOPAEDIC TERMS
Define the following terms:
Arthroplasty
P694

A

Total joint replacement (most last 10 to

15 years)

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40
Q

ORTHOPAEDIC TERMS
Define the following terms:
Arthrodesis
P694

A

Joint fusion with removal of articular

surfaces

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41
Q

ORTHOPAEDIC TERMS
Define the following terms:
Osteotomy
P694

A 
Cutting bone (usually wedge resection) to
help realigning of joint surfaces
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42
Q

ORTHOPAEDIC TERMS
Define the following terms:
Non-union
P694

A

Failure of fractured bone ends to fuse

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43
Q

ORTHOPAEDIC TERMS
Define each of the
following:
Diaphysis

P694

A

Main shaft of long bone

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44
Q 
ORTHOPAEDIC TERMS
Define each of the
following:
Metaphysis
P694
A

Flared end of long bone

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45
Q 
ORTHOPAEDIC TERMS
Define each of the
following:
Physis
P694
A

Growth plate, found only in immature

bone

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46
Q 
TRAUMA GENERAL PRINCIPLES
Define extremity
examination in fractured
extremities.
P694
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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47
Q

TRAUMA GENERAL PRINCIPLES
Which x-rays should be
obtained?
P694

A 
Two views (also joint above and below
fracture)
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48
Q

TRAUMA GENERAL PRINCIPLES
How are fractures
described?
P694

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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49
Q 
TRAUMA GENERAL PRINCIPLES
How do you define the
degree of angulation,
displacement, or both?
P694
A

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

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50
Q

TRAUMA GENERAL PRINCIPLES
Identify each numbered
structure:
P695 (picture)

A
  1. Diaphysis
  2. Metaphysis
  3. Physis
  4. Epiphysis
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51
Q 
FRACTURES
Define the following
patterns of fracture:
Closed fracture
P695
A

Intact skin over fracture/hematoma

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52
Q 
FRACTURES
Define the following
patterns of fracture:
Open fracture
P695
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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53
Q 
FRACTURES
Define the following
patterns of fracture:
Simple fracture
P695
A

One fracture line, two bone fragments

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54
Q 
FRACTURES
Define the following
patterns of fracture:
Comminuted fracture
P695 (picture)
A

Results in more than two bone fragments;

a.k.a. fragmentation

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55
Q 
RACTURES
Define the following
patterns of fracture:
Segmental fracture
P696 (picture)
A

Two complete fractures with a “segment”

in between

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56
Q 
RACTURES
Define the following
patterns of fracture:
Transverse fracture
P696 (picture)
A

Fracture line perpendicular to long axis

of bone

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57
Q 
RACTURES
Define the following
patterns of fracture:
Oblique fracture
P696 (picture)
A

Fracture line creates an oblique angle

with long axis of bone

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58
Q 
RACTURES
Define the following
patterns of fracture:
Spiral fracture
P697 (picture)
A

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

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59
Q 
RACTURES
Define the following
patterns of fracture:
Longitudinal fracture
P697
A

Fracture line parallel to long axis of bone

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60
Q 
RACTURES
Define the following
patterns of fracture:
Impacted fracture
P697
A

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

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61
Q 
RACTURES
Define the following
patterns of fracture:
Pathologic fracture
P697
A

Fracture through abnormal bone (e.g.,

tumor-laden or osteoporotic bone)

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62
Q 
RACTURES
Define the following
patterns of fracture:
Stress fracture
P697
A

Fracture in normal bone from cyclic

loading on bone

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63
Q 
RACTURES
Define the following
patterns of fracture:
Greenstick fracture
P697 (picture)
A

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

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64
Q 
RACTURES
Define the following
patterns of fracture:
Torus fracture
P698
A

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

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65
Q 
RACTURES
Define the following
patterns of fracture:
Avulsion fracture
P698 (picture)
A

Fracture in which tendon is pulled from

bone, carrying with it a bone chip

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66
Q 
RACTURES
Define the following
patterns of fracture:
Periarticular fracture
P698
A

Fracture close to but not involving the joint

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67
Q 
RACTURES
Define the following
patterns of fracture:
Intra-articular fracture
P698
A 
Fracture through the articular surface of
a bone (usually requires ORIF)
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68
Q 
RACTURES
Define the following specific
fractures:
Colles’ fracture
P698 (picture)
A

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

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69
Q 
RACTURES
Define the following specific
fractures:
Smith’s fracture
P698
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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70
Q 
RACTURES
Define the following specific
fractures:
Jones’ fracture
P699
A

Fracture at the base of the fifth

metatarsal diaphysis

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71
Q 
RACTURES
Define the following specific
fractures:
Bennett’s fracture
P699 (picture)
A 
Fracture-dislocation of the base of the
first metacarpal (thumb) with disruption
of the carpometacarpal joint
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72
Q 
RACTURES
Define the following specific
fractures:
Boxer’s fracture
P699 (picture)
A

Fracture of the metacarpal neck,

“classically” of the small finger

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73
Q 
RACTURES
Define the following specific
fractures:
Nightstick fracture
P699
A

Ulnar fracture

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74
Q 
RACTURES
Define the following specific
fractures:
Clay shoveler’s avulsion
fracture
P699
A

Fracture of spinous process of C6–C7

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75
Q 
RACTURES
Define the following specific
fractures:
Hangman’s fracture
P699
A

Fracture of the pedicles of C2

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76
Q 
RACTURES
Define the following specific
fractures:
Transcervical fracture
P699
A

Fracture through the neck of the femur

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77
Q 
RACTURES
Define the following specific
fractures:
Tibial plateau fracture
P700
A

Intra-articular fracture of the proximal tibia

the plateau is the flared proximal end

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78
Q 
RACTURES
Define the following specific
fractures:
Monteggia fracture
P700
A

Fracture of the proximal third of the ulna

with dislocation of the radial head

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79
Q 
RACTURES
Define the following specific
fractures:
Galeazzi fracture
P700
A

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

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80
Q 
RACTURES
Define the following specific
fractures:
Tibial “plateau” fracture
P700 (picture)
A

Proximal tibial fracture

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81
Q 
RACTURES
Define the following specific
fractures:
“Pilon” fracture
P700 (picture)
A

Distal tibial fracture

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82
Q 
RACTURES
Define the following specific
fractures:
Pott’s fracture
P700
A

Fracture of distal fibula

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83
Q 
RACTURES
Define the following specific
fractures:
Pott’s disease
P700
A

Tuberculosis of the spine

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84
Q

ORTHOPAEDIC TRAUMA
What are the major
orthopaedic emergencies?
P701

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)
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85
Q

ORTHOPAEDIC TRAUMA
What is the main risk when
dealing with an open fracture?
P701

A

Infection

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86
Q

ORTHOPAEDIC TRAUMA
Which fracture has the
highest mortality?
P701

A 
Pelvic fracture (up to 50% with open
pelvic fractures)
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87
Q

ORTHOPAEDIC TRAUMA
What factors determine the
extent of injury (3)?
P701

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
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88
Q 
ORTHOPAEDIC TRAUMA
What is the acronym for
indications for OPEN
reduction?
P701
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
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89
Q 
ORTHOPAEDIC TRAUMA
Define open fractures by
Gustilo-Anderson
classification:
Grade I?
P701
A

<1-cm laceration

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90
Q 
ORTHOPAEDIC TRAUMA
Define open fractures by
Gustilo-Anderson
classification:
Grade II?
P701
A

> 1 cm, minimal soft tissue damage

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5
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91
Q 
ORTHOPAEDIC TRAUMA
Define open fractures by
Gustilo-Anderson
classification:
Grade IIIA?
P702
A

Open fracture with massive tissue

devitalization/loss, contamination

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92
Q 
ORTHOPAEDIC TRAUMA
Define open fractures by
Gustilo-Anderson
classification:
Grade IIIB?
P702
A

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

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93
Q 
ORTHOPAEDIC TRAUMA
Define open fractures by
Gustilo-Anderson
classification:
Grade IIIC?
P702
A

Open fracture with major vascular injury

requiring repair

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94
Q

ORTHOPAEDIC TRAUMA
What structures are at risk
with a humeral fracture?
P702

A

Radial nerve, brachial artery

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95
Q 
ORTHOPAEDIC TRAUMA
What must be done when
both forearm bones are
broken?
P702
A

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

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96
Q

ORTHOPAEDIC TRAUMA
How have femoral fractures
been repaired traditionally?
P702

A

Traction for 4 to 6 weeks

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97
Q

ORTHOPAEDIC TRAUMA
What is the newer technique?
P702

A

Intramedullary rod placement

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98
Q

ORTHOPAEDIC TRAUMA
What are the advantages?
P702

A

Nearly immediate mobility with

decreased morbidity/mortality

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99
Q

ORTHOPAEDIC TRAUMA
What is the chief concern
following tibial fractures?
P702

A

Recognition of associated compartment

syndrome

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100
Q

ORTHOPAEDIC TRAUMA
What is suggested by pain in
the anatomic snuff-box?
P702

A

Fracture of scaphoid bone (a.k.a.

navicular fracture)

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101
Q 
ORTHOPAEDIC TRAUMA
What is the most common
cause of a “pathologic”
fracture in adults?
P702
A

Osteoporosis

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102
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What is acute compartment
syndrome?
P703
A

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

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103
Q

ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
How is it diagnosed?
P703

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)
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104
Q

ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are the causes?
P703

A

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

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105
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are common causes
of forearm compartment
syndrome?
P703
A

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

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106
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What is Volkmann’s
contracture?
P703
A

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

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107
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What is the most common
site of compartment
syndrome?
P703
A

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

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108
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What situations should
immediately alert one to be
on the lookout for a
developing compartment
syndrome (4)?
P703
A 
1. Supracondylar elbow fractures in
    children
2. Proximal/midshaft tibial fractures
3. Electrical burns
4. Arterial/venous disruption
109
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are the symptoms of
compartment syndrome?
P703
A

Pain, paresthesias, paralysis

110
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are the signs of
compartment syndrome?
P703
A

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

111
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
Can a patient have a
compartment syndrome
with a palpable or Dopplerdetectable
distal pulse?
P704
112
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are the possible
complications of
compartment syndrome?
P704
A

Muscle necrosis, nerve damage,

contractures, myoglobinuria

113
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What is the initial treatment
of the orthopaedic patient
developing compartment
syndrome?
P704
A

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

114
Q 
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What is the definitive
treatment of compartment
syndrome?
P704
A

Fasciotomy within 4 hours (6–8 hours

maximum) if at all possible

115
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Radial
P704
A

Wrist extension; dorsal web space;

sensation: between thumb and index finger

116
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Ulnar
P704
A

Little finger abduction; sensation: little

finger-distal ulnar aspect

117
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Median
P704
A

Thumb opposition or thumb pinch

sensation: index finger-distal radial aspect

118
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Axillary
P704
A

Arm abduction; sensation: deltoid patch

on lateral aspect of upper arm

119
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the motor and
sensation tests used to assess
the following peripheral
nerves:
Musculocutaneous
P704
A

Elbow (biceps) flexion; lateral forearm

sensation

120
Q

ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
How is a peripheral nerve
injury treated?
P704

A

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

121
Q

ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
What fracture is associated
with a calcaneus fracture?
P704

A

L-spine fracture (usually from a fall)

122
Q

ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
Name the nerves of the
brachial plexus.
P705

A

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

123
Q 
ORTHOPAEDIC TRAUMAMISCELLANEOUS TRAUMA MISCELLANEOUS TRAUMA INJURIES AND COMPLICATIONS
What are the two indications
for operative exploration
with a peripheral nerve
injury?
P705
A
  1. Loss of nerve function after reduction
    of fracture
  2. No EMG signs of nerve regeneration
    after 8 weeks (nerve graft)
124
Q 
DISLOCATIONS
SHOULDER
What is the most common
type?
P705
A

95% are anterior (posterior are associated

with seizures or electrical shock)

125
Q 
DISLOCATIONS
SHOULDER
Which two structures are at
risk?
P705
A
  1. Axillary nerve

2. Axillary artery

126
Q

DISLOCATIONS
SHOULDER
How is it diagnosed?
P705

A

Indentation of soft tissue beneath

acromion

127
Q 
DISLOCATIONS
SHOULDER
What are the three
treatment steps?
P705
A
  1. Reduction via gradual traction
  2. Immobilization for 3 weeks in internal
    rotation
  3. ROM exercises
128
Q 
DISLOCATIONS
ELBOW
What is the most common
type?
P705
129
Q 
DISLOCATIONS
ELBOW
Which three structures are
at risk?
P705
A
  1. Brachial artery
  2. Ulnar nerve
  3. Median nerve
130
Q

DISLOCATIONS
ELBOW
What is the treatment?
P705

A

Reduce and splint for 7 to 10 days

131
Q 
DISLOCATIONS
HIP
When should hip
dislocations be reduced?
P705
A

Immediately, to decrease risk of avascular

necrosis; “reduce on the x-ray table!”

132
Q 
DISLOCATIONS
HIP
What is the most common
cause of a hip dislocation?
P705
A

High velocity trauma (e.g., MVC)

133
Q 
DISLOCATIONS
HIP
What is the most common
type?
P706
A

Posterior—“dashboard dislocation”—
often involves fracture of posterior lip of
acetabulum

134
Q

DISLOCATIONS
HIP
Which structures are at risk?
P706

A

Sciatic nerve; blood supply to femoral

head—avascular necrosis (AVN)

135
Q

DISLOCATIONS
HIP
What is the treatment?
P706

A

Closed or open reduction

136
Q

DISLOCATIONS
KNEE
What are the common types?
P706

A

Anterior or posterior

137
Q

DISLOCATIONS
KNEE
Which structures are at risk?
P706

A

Popliteal artery and vein, peroneal
nerve—especially with posterior
dislocation, ACL, PCL (Note: need
arteriogram)

138
Q

DISLOCATIONS
KNEE
What is the treatment?
P706

A

Immediate attempt at relocation
(do not wait to x-ray), arterial repair,
and then ligamentous repair (delayed
or primary)

139
Q 
DISLOCATIONS
THE KNEE
What are the five ligaments
of the knee?
P706 (picture)
A
  1. Anterior Cruciate Ligament (ACL),
  2. Posterior Cruciate Ligament (PCL),
  3. Medial Collateral Ligament (MCL),
  4. Lateral Collateral Ligament (LCL),
  5. Patellar Ligament
140
Q 
DISLOCATIONS
THE KNEE
What is the Lachman test
for a torn ACL?
P707 (picture)
A

Thigh is secured with one hand while the

other hand pulls the tibia anteriorly

141
Q 
DISLOCATIONS
THE KNEE
What is the meniscus of the
knee?
P707
A

Cartilage surface of the tibia plateau
(lateral and medial meniscus); tears are
repaired usually by arthroscopy with
removal of torn cartilage fragments

142
Q

DISLOCATIONS
THE KNEE
What is McMurray’s sign?
P707

A

Seen with a medial meniscus tear: medial
tenderness of knee with flexion and
internal rotation of the knee

143
Q 
DISLOCATIONS
THE KNEE
What is the “unhappy
triad”?
P707
A

Lateral knee injury resulting in:

1. ACL tear
2. MCL tear
3. Medial meniscus injury
144
Q

DISLOCATIONS
THE KNEE
What is a “locked knee”?
P707

A

Meniscal tear that displaces and
interferes with the knee joint and
prevents complete extension

145
Q 
DISLOCATIONS
THE KNEE
What is a “bucket-handle
tear”?
P707
A

Meniscal tear longitudinally along contour

of normal “C” shape of the meniscus

146
Q 
DISLOCATIONS
THE KNEE
In collateral ligament and
menisci injuries, which are
more common, the medial
or the lateral?
P707
147
Q

ACHILLES TENDON RUPTURE
What are the signs of an
Achilles tendon rupture?
P707

A 
Severe calf pain, also bruised swollen
calf, two ends of ruptured tendon may be
felt, patient will have weak plantar flexion
from great toe flexors that should be
intact; patient often hears a “pop”
148
Q

ACHILLES TENDON RUPTURE
Name the test for an
INTACT Achilles tendon.
P708 (picture

A

Thompson’s test: a squeeze of the
gastrocnemius muscle results in plantar
flexion of the foot

149
Q

ACHILLES TENDON RUPTURE
What is the treatment for an
Achilles tendon rupture?
P708

A

Young = surgical repair
Elderly = many can be treated with
progressive splints

150
Q

ROTATOR CUFF
What four muscles form the
rotator cuff?
P708

A

Think: “SITS”:

  1. Supraspinatus, etc.
  2. Infraspinatus
  3. Teres minor
  4. Subscapularis
151
Q

ROTATOR CUFF
When do tears usually occur?
P708

A

Fifth decade

152
Q

ROTATOR CUFF
What is the usual history?
P708

A

Intermittent shoulder pain especially
with overhead activity, followed by an
episode of acute pain corresponding to a
tendon tear; weak abduction

153
Q

ROTATOR CUFF
What is the treatment?
P708

A

Most tears: symptomatic pain relief
Later: if poor muscular function persists,
surgical repair is indicated

154
Q

ROTATOR CUFF
What is Volkmann’s
contracture?
P708

A

Contracture of forearm flexors secondary

to forearm compartment syndrome

155
Q

ROTATOR CUFF
What is the usual cause of
Volkmann’s contracture?
P709

A

Brachial artery injury, supracondylar
humerus fracture, radius/ulnar fracture,
crush injury, etc.

156
Q

MISCELLANEOUS
Define the following terms:
Dupuytren’s contracture
P709

A

Thickening and contracture of palmar

fascia; incidence increases with age

157
Q

MISCELLANEOUS
Define the following terms:
Charcot’s joint
P709

A

Joint arthritis from peripheral neuropathy

158
Q

MISCELLANEOUS
Define the following terms:
Tennis elbow
P709

A

Tendonitis of the lateral epicondyle of
the humerus; classically seen in tennis
players

159
Q

MISCELLANEOUS
Define the following terms:
Turf toe
P709

A

Hyperextension of the great toe (tear of
the tendon of the flexor hallucis brevis);
classically seen in football players

160
Q

MISCELLANEOUS
Define the following terms:
Shin splints
P709

A

Exercise-induced anterior compartment
hypertension (compartment syndrome);
seen in runners

161
Q

MISCELLANEOUS
Define the following terms:
Heel spur
P709

A

Plantar fasciitis with abnormal bone growth
in the plantar fascia; classically seen in
runners and walkers

162
Q

MISCELLANEOUS
Define the following terms:
Nightstick fracture
P709

A

Ulnar fracture

163
Q

MISCELLANEOUS
Define the following terms:
Kienbock’s disease
P709

A

Avascular necrosis of the lunate

164
Q

MISCELLANEOUS
What is traumatic myositis?
P709

A

Abnormal bone deposit in a muscle after
blunt trauma deep muscle contusion
(benign)

165
Q 
MISCELLANEOUS
How does a “cast saw”
cut the cast but not the
underlying skin?
P709
A 
It is an “oscillating” saw (designed by
Dr. Homer Stryker in 1947) that goes
back and forth cutting anything hard
while moving the skin back and forth
without injuring it
166
Q

ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What is osteomyelitis?
P710

A

Inflammation/infection of bone marrow

and adjacent bone

167
Q 
ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What are the most likely
causative organisms?
P710
A 
Neonates: Staphylococcus aureus, gramnegative
    streptococcus
Children: S. aureus, Haemophilus
    influenzae, streptococci
Adults: S. aureus
Immunocompromised/drug addicts:
    S. aureus gram-negative
Sickle cell: Salmonella
168
Q 
ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What is the most common
organism isolated in
osteomyelitis in the general
adult population?
P710
169
Q 
ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What is the most common
isolated organism in patients
with sickle cell disease?
P710
A

Salmonella

170
Q 
ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What is seen on physical
examination?
P710
A

Tenderness, decreased movement,

swelling

171
Q

ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What are the diagnostic steps?
P710

A

History and physical examination, needle
aspirate, blood cultures, CBC, ESR, bone
scan

172
Q 
ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What are the treatment
options?
P710
A

Antibiotics with or without surgical

drainage

173
Q

ORTHOPAEDIC INFECTIONS
OSTEOMYELITIS
What is a Marjolin’s ulcer?
P710

A

Squamous cell carcinoma that arises in a

chronic sinus from osteomyelitis

174
Q

ORTHOPAEDIC INFECTIONS
SEPTIC ARTHRITIS
What is it?
P710

A

Inflammation of a joint beginning as
synovitis and ending with destruction of
articular cartilage if left untreated

175
Q 
ORTHOPAEDIC INFECTIONS
SEPTIC ARTHRITIS
What are the causative
agents?
P711
A

Same as in osteomyelitis, except that
gonococcus is a common agent in the
adult population

176
Q 
ORTHOPAEDIC INFECTIONS
SEPTIC ARTHRITIS
What are the findings on
physical examination?
P711
A

Joint pain, decreased motion, joint

swelling, joint warm to the touch

177
Q 
ORTHOPAEDIC INFECTIONS
SEPTIC ARTHRITIS
What are the diagnostic
steps?
P711
A 
Needle aspirate (look for pus; culture plus
Gram stain), x-ray, blood cultures, ESR
178
Q

ORTHOPAEDIC INFECTIONS
SEPTIC ARTHRITIS
What is the treatment?
P711

A

Decompression of the joint via needle
aspiration and IV antibiotics; hip, shoulder,
and spine must be surgically incised,
débrided, and drained

179
Q

ORTHOPAEDIC TUMORS
What is the most common
type in adults?
P711

A

Metastatic!

180
Q

ORTHOPAEDIC TUMORS
What are the common
sources?
P711

A

Breast, lung, prostate, kidney, thyroid,

and multiple myeloma

181
Q

ORTHOPAEDIC TUMORS
What is the usual
presentation?
P711

A

Bone pain or as a pathologic fracture

182
Q 
ORTHOPAEDIC TUMORS
What is the most common
primary malignant bone
tumor?
P711
A

Multiple myeloma (45%)

183
Q 
ORTHOPAEDIC TUMORS
What is the differential
diagnosis of a possible bone
tumor?
P711
A 
Metastatic disease
Primary bone tumors
Metabolic disorders (e.g.,
    hyperparathyroidism)
Infection
184
Q

ORTHOPAEDIC TUMORS
What are the benign bone
tumors (8)?
P711

A
  1. Osteochondroma
  2. Enchondroma
  3. Unicameral/aneurysmal bone cysts
  4. Osteoid osteoma
  5. Chondroblastoma
  6. Fibroxanthoma
  7. Fibrous dysplasia
  8. Nonossifying fibroma
185
Q

ORTHOPAEDIC TUMORS
What are the malignant
bone tumors (7)?
P712

A
  1. Multiple myeloma
  2. Osteosarcoma
  3. Chondrosarcoma
  4. Ewing’s sarcoma
  5. Giant cell tumor (locally malignant)
  6. Malignant melanoma
  7. Metastatic
186
Q 
ORTHOPAEDIC TUMORS
Compare benign and malignant bone tumors in
terms of:
Size
P712
A

Benign—small; 1 cm

187
Q 
ORTHOPAEDIC TUMORS
Compare benign and malignant bone tumors in
terms of:
Bone reaction
P712
A

Benign—sclerotic bone reaction

Malignant—little reaction

188
Q 
ORTHOPAEDIC TUMORS
Compare benign and malignant bone tumors in
terms of:
Margins
P712
A

Benign—sharp

Malignant—poorly defined

189
Q 
ORTHOPAEDIC TUMORS
Compare benign and malignant bone tumors in
terms of:
Invasive
P712
A

Benign—confined to bone
Malignant—often extends to surrounding
tissues

190
Q

ORTHOPAEDIC TUMORS
Are most pediatric bone
tumors benign or malignant?
P712

A

80% are benign (most common is

osteochondroma)

191
Q

ORTHOPAEDIC TUMORS
Are most adult bone tumors
benign or malignant?
P712

A

66% are malignant (most commonly

metastatic)

192
Q

ORTHOPAEDIC TUMORS
What are the four diagnostic
steps?
P712

A
  1. PE/lab tests
  2. Radiographs
  3. CT scan, technetium scan, or both
  4. Biopsy
193
Q

ORTHOPAEDIC TUMORS
What are the radiographic
signs of malignant tumors?
P712

A 
Large size
Aggressive bone destruction, poorly
    defined margins
Ineffective bone reaction to tumor
Extension to soft tissues
194
Q

ORTHOPAEDIC TUMORS
What are the radiographic
signs of benign tumors?
P712

A 
Small
Well circumscribed, sharp margins
Effective bone reaction to the tumor
    (sclerotic periostitis)
No extension—confined to bone
195
Q 
ORTHOPAEDIC TUMORS
What are some specific
radiographic findings of the
following:
Osteosarcoma?
P713
A

“Sunburst” pattern

196
Q 
ORTHOPAEDIC TUMORS
What are some specific
radiographic findings of the
following:
Fibrous dysplasia
P713
A

Bubbly lytic lesion, “ground glass”

197
Q 
ORTHOPAEDIC TUMORS
What are some specific
radiographic findings of the
following:
Ewing’s sarcoma
P713
A

“Onion skinning”

198
Q

ORTHOPAEDIC TUMORS
What is the mainstay of
treatment for bone tumours?
P713

A 
Surgery (excision plus débridement) for
both malignant and benign lesions;
radiation therapy and chemotherapy as
adjuvant therapy for many malignant
tumors
199
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the usual age at
presentation?
P713
A

10 to 20 years

200
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the gender
distribution?
P713
A

Male > female

201
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the most common
location?
P713
A

≈66% in the distal femur, proximal tibi

202
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the radiographic
sine qua non?
P713
A

Bone formation somewhere within tumor

203
Q

ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the treatment?
P713

A

Resection (limb sparing if possible) plus

chemotherapy

204
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the 5-year survival
rate?
P713
205
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the most common
site of metastasis?
P713
206
Q 
ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is the most common
benign bone tumor?
P713
A

Osteochondroma; it is cartilaginous
in origin and may undergo malignant
degeneration

207
Q

ORTHOPAEDIC TUMORS
OSTEOSARCOMA
What is a chondrosarcoma?
P713

A

Malignant tumor of cartilaginous origin;
presents in middle-aged and older
patients and is unresponsive to
chemotherapy and radiotherapy

208
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the usual
presentation?
P714
A

Pain, swelling in involved area

209
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the most common
location?
P714
A

Around the knee (distal femur,

proximal tibia)

210
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the usual age at
presentation?
P714
A

Evenly spread among those younger than

20 years of age

211
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What are the associated
radiographic findings?
P714
A 
Lytic lesion with periosteal reaction
    termed “onion skinning,” which is
    calcified layering
Central areas of tumor can undergo
    liquefaction necrosis, which may be
    confused with purulent infection
    (particularly in a child with fever,
    leukocytosis, and bone pain)
212
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is a memory aid for
Ewing’s sarcoma?
P714
A

“TKO Ewing”:
Twenty years old or younger
Knee joint
“Onion skinning”

213
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the 5-year survival
rate?
P714
214
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
How can Ewing’s sarcoma
mimic the appearance of
osteomyelitis?
P714
A

Bone cysts

215
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is a unicameral bone
cyst?
P714
A

Fluid-filled cyst most commonly found in
the proximal humerus in children 5 to 15
years of age

216
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the usual
presentation?
P714
A

Asymptomatic until pathologic fracture

217
Q

ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the treatment?
P714

A

Steroid injections

218
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is an aneurysmal bone
cyst?
P714
A

Hemorrhagic lesion that is locally
destructive by expansile growth, but does
not metastasize

219
Q 
ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the usual
presentation?
P715
A

Pain and swelling; pathologic fractures

are rare

220
Q

ORTHOPAEDIC TUMORS
EWING’S SARCOMA
What is the treatment?
P715

A

Curettage and bone grafting

221
Q

ARTHRITIS
Which arthritides are
classified as degenerative?
P715

A

Osteoarthritis

Post-traumatic arthritis

222
Q

ARTHRITIS
What signs characterize
osteoarthritis?
P715

A

Heberden’s nodes/Bouchard’s nodes
Symmetric destruction, usually of the
hip, knee, or spine

223
Q

ARTHRITIS
What are Bouchard’s nodes?
P715

A

Enlarged PIP joints of the hand from

cartilage/bone growth

224
Q

ARTHRITIS
What are Heberden’s nodes?
P715

A

Enlarged DIP joints of the hand from

cartilage/bone growth

225
Q

ARTHRITIS
What is post-traumatic
arthritis?
P715

A

Usually involves one joint of past trauma

226
Q 
ARTHRITIS
What are the treatment
options for degenerative
arthritis (3)?
P715
A
  1. NSAIDS for acute flare-ups, not for
    long-term management
  2. Local corticosteroid injections
  3. Surgery
227
Q

ARTHRITIS
What are the characteristics
of rheumatoid arthritis?
P715

A 
Autoimmune reaction in which invasive
pannus attacks hyaline articular cartilage;
rheumatoid factor (anti-IgG/IgM) in 80%
of patients; 3 more common in
women; skin nodules (e.g., rheumatoid
nodule)
228
Q

ARTHRITIS
What is pannus?
P715

A

Inflammatory exudate overlying synovial

cells inside the joint

229
Q 
ARTHRITIS
What are the classic hand
findings with rheumatoid
arthritis?
P715
A

Wrist: radial deviation
Fingers: ulnar deviation

230
Q 
ARTHRITIS
What are the surgical
management options for
joint/bone diseases (3)?
P715
A
  1. Arthroplasty
  2. Arthrodesis (fusion)
  3. Osteotomy
231
Q 
ARTHRITIS
What is the major difference
between gout and
pseudogout?
P716
A 
Gout: caused by urate deposition,
    negative birefringent, needle crystal
Pseudogout: caused by calcium
    pyrophosphate positive birefringent
    square crystals (Think: Positive
    Square crystals = PSeudogout)
232
Q

ARTHRITIS
What is a Charcot’s joint?
P716

A

Arthritic joint from peripheral

neuropathy

233
Q 
PEDIATRIC ORTHOPAEDICS
What are the major
differences between
pediatric and adult bones?
P716
A 
Children: increased bone flexibility
and bone healing (thus, many fractures
are treated closed, whereas an adult
would require O.R.I.F.), physis (weak
point)
234
Q

PEDIATRIC ORTHOPAEDICS
What types of fractures are
unique to children?
P716

A

Greenstick fracture
Torus fracture
Fracture through physis

235
Q

PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What does it describe?
P716

A

Fractures in children involving physis

236
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What does it indicate high
risk of?
P716
A

Potential growth arrest

237
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following terms:
Salter I
P716
A

Through physeal plate only

238
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following terms:
Salter II
P716
A

Involves metaphysis and physis

239
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following terms:
Salter III
P716
A

Involves physis and epiphysis

240
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following terms:
Salter IV
P716
A

Extends from metaphysis through physis,

into epiphysis

241
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following terms:
Salter V
P716
A

Axial force crushes physeal plate

242
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following fractures
by Salter-Harris grade:
(see Picture)
P717 (picture)
A

Salter III

243
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following fractures
by Salter-Harris grade:
(see Picture)
P717 (picture)
244
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following fractures
by Salter-Harris grade:
(see Picture)
P717 (picture)
245
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following fractures
by Salter-Harris grade:
(see Picture)
P717 (picture)
246
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Define the following fractures
by Salter-Harris grade:
(see Picture)
P718 (picture)
247
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What acronym can help
you remember the Salter
classifications?
P718 (Picture)
A 
“SALTR”:
Separated = type I
Above = type II
Lower=  type III
Through = type IV
Ruined = type V
248
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What is the simple
numerical method for
remembering the Salter-
Harris classification?
P718 (Picture)
A

(N = normal)

249
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
Why is the growth plate of
concern in childhood
fractures?
P718 (Picture)
A 
Growth plate represents the “weak link”
in the child’s musculoskeletal system;
fractures involving the growth plate of
long bones may compromise normal
growth, so special attention should be
given to them
250
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What is a chief concern
when oblique/spiral
fractures of long bones are
seen in children?
P719
A

Child abuse is a possibility; other signs of

abuse should be investigated

251
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What is usually done during
reduction of a femoral
fracture?
P719
A 
Small amount of overlap is allowed
because increased vascularity from injury
may make the affected limb longer if
overlap is not present; treatment after
reduction is a spica cast
252
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
What is unique about
ligamentous injury in
children?
P719
A

Most “ligamentous” injuries are actually

fractures involving the growth plate!

253
Q 
PEDIATRIC ORTHOPAEDICS
SALTER-HARRIS CLASSIFICATION
children?
What two fractures have a
high incidence of associated
compartment syndrome?
P719
A
  1. Tibial fractures
  2. Supracondylar fractures of humerus
    (Volkmann’s contracture)
254
Q

PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
What is the epidemiology?
P719

A

Female > male, firstborn children,
breech
Presentation, 1 in 1000 births

255
Q 
PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
What percentage are
bilateral?
P719
256
Q

PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
How is the diagnosis made?
P719

A

Barlow’s maneuver, Ortolani’s sign

Radiographic confirmation is required

257
Q

PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
What is Barlow’s maneuver?
P719

A 
Detects unstable hip: patient is placed in
the supine position and attempt is made
to push femurs posteriorly with knees at
90	/hip flexed and hip will dislocate
(Think: push Back = Barlow)
258
Q

PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
What is Ortolani’s sign?
P719

A

“Clunk” produced by relocation of a
dislocated femoral head when the
examiner abducts the flexed hip and lifts
the greater trochanter anteriorly; detects
a dislocated hip (Think: Out = Ortolani’s)

259
Q

PEDIATRIC ORTHOPAEDICS
CONGENITAL HIP DISLOCATION
What is the treatment?
P719

A

Pavlik harness—maintains hip reduction

with hips flexed at 100 to 110

260
Q

PEDIATRIC ORTHOPAEDICS
SCOLIOSIS
What is the definition?
P720

A

Lateral curvature of a portion of the spine
Nonstructural: corrects with positional
change
Structural: does not correct

261
Q 
PEDIATRIC ORTHOPAEDICS
SCOLIOSIS
What are three treatment
options?
P720
A
  1. Observation
  2. Braces (Milwaukee brace)
  3. Surgery
262
Q 
PEDIATRIC ORTHOPAEDICS
SCOLIOSIS
What are the indications for
surgery for scoliosis?
P720
A

Respiratory compromise
Rapid progression
Curves >40
Failure of brace

263
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Legg-Calvé-Perthes disease
P720
A

Idiopathic avascular necrosis of femoral

head in children

264
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Slipped capital femoral
epiphysis
P720
A 
Migration of proximal femoral epiphysis
    on the metaphysis in children; the
    proximal femoral epiphysis externally
    rotates and displaces anteriorly from
    the capital femoral epiphysis, which
    stays reduced in the acetabulum
(Note: Hip pain in children often
    presents as knee pain)
265
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Blount’s disease
P720
A

Idiopathic varus bowing of tibia

266
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Nursemaid’s elbow
P720
A

Dislocation of radial head (from pulling

toddler’s arm)

267
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Little League elbow
P720
A

Medial epicondylitis

268
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
Define the following terms:
Osgood-Schlatter’s
disease
P720
A 
Apophysitis of the tibial tubercle resulting
from repeated powerful contractions of
the quadriceps; seen in adolescents with
an open physis
    Treatment of mild cases: activity
        restriction
    Treatment of severe cases: cast
269
Q 
PEDIATRIC ORTHOPAEDICS
MISCELLANEOUS
What is the most common
pediatric bone tumor?
P720
A

Osteochondroma (Remember, 80% of

bone tumors are benign in children)

Section III Subspecialty Surgery P517 (11 decks)

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