Orthopaedic Surgery, C74 P690-720 Flashcards
ORTHOPAEDIC TERMS What do the following abbreviations stand for: ORIF? P690
Open Reduction Internal Fixation
ORTHOPAEDIC TERMS What do the following abbreviations stand for: ROM? P690
Range Of Motion
ORTHOPAEDIC TERMS What do the following abbreviations stand for: FROM? P690
Full Range Of Motion
ORTHOPAEDIC TERMS What do the following abbreviations stand for: ACL? P690
Anterior Cruciate Ligament
ORTHOPAEDIC TERMS What do the following abbreviations stand for: PCL? P690
Posterior Cruciate Ligament
ORTHOPAEDIC TERMS What do the following abbreviations stand for: MCL? P690
Medial Collateral Ligament
ORTHOPAEDIC TERMS What do the following abbreviations stand for: PWB? P690
Partial Weight Bearing
ORTHOPAEDIC TERMS What do the following abbreviations stand for: FWB? P690
Full Weight Bearing
ORTHOPAEDIC TERMS What do the following abbreviations stand for: WBAT? P690
Weight Bearing As Tolerated
ORTHOPAEDIC TERMS What do the following abbreviations stand for: THA? P691
Total Hip Arthroplasty
ORTHOPAEDIC TERMS What do the following abbreviations stand for: TKA? P691
Total Knee Arthroplasty
ORTHOPAEDIC TERMS What do the following abbreviations stand for: THR? P691
Total Hip Replacement
ORTHOPAEDIC TERMS What do the following abbreviations stand for: TKR? P691
Total Knee Replacement
ORTHOPAEDIC TERMS What do the following abbreviations stand for: PROM? P691
Passive Range Of Motion
ORTHOPAEDIC TERMS What do the following abbreviations stand for: AROM? P691
Active Range Of Motion
ORTHOPAEDIC TERMS What do the following abbreviations stand for: AFO? P691
Ankle Foot Orthotic
ORTHOPAEDIC TERMS What do the following abbreviations stand for: AVN? P691
AVascular Necrosis
ORTHOPAEDIC TERMS
Define the following terms:
Supination
P691
Palm up
ORTHOPAEDIC TERMS
Define the following terms:
Pronation
P691
Palm down
ORTHOPAEDIC TERMS
Define the following terms:
Plantarflexion
P691
Foot down at ankle joint (plant foot in
ground)
ORTHOPAEDIC TERMS
Define the following terms:
Foot dorsiflexion
P691
Foot up at ankle joint
ORTHOPAEDIC TERMS
Define the following terms:
Adduction
P691
Movement toward the body
ADDuction = ADD to the body
ORTHOPAEDIC TERMS
Define the following terms:
Abduction
P691
Movement away from the body
ORTHOPAEDIC TERMS
Define the following terms:
Inversion
P691
Foot sole faces midline
ORTHOPAEDIC TERMS
Define the following terms:
Eversion
P691
Foot sole faces laterally
ORTHOPAEDIC TERMS
Define the following terms:
Volarflexion
P691
Hand flexes at wrist joint toward flexor
tendons
ORTHOPAEDIC TERMS
Define the following terms:
Wrist dorsiflexion
P691
Hand flexes at wrist joint toward extensor
tendons
ORTHOPAEDIC TERMS
Define the following terms:
Allograft bone
P691
Bone from human donor other than
patient
ORTHOPAEDIC TERMS
Define the following terms:
Reduction
P692
Maneuver to restore proper alignment to
fracture or joint
ORTHOPAEDIC TERMS
Define the following terms:
Closed reduction
P692
Reduction done without surgery
e.g., casts, splints
ORTHOPAEDIC TERMS
Define the following terms:
Open reduction
P692
Surgical reduction
ORTHOPAEDIC TERMS
Define the following terms:
Fixation
P692
Stabilization of a fracture after reduction
by means of surgical placement of
hardware that can be external or internal
(e.g., pins, plates, screws)
ORTHOPAEDIC TERMS
Define the following terms:
Tibial pin
P692 (picture)
Pin placed in the tibia for treating femur
or pelvic fractures by applying skeletal
traction
ORTHOPAEDIC TERMS Define the following terms: Unstable fracture or dislocation P692
Fracture or dislocation in which further
deformation will occur if reduction is not
performed
ORTHOPAEDIC TERMS
Define the following terms:
Varus
P693 (picture)
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)
ORTHOPAEDIC TERMS
Define the following terms:
Valgus
P693 (picture)
Extremity abnormality with apex of
defect pointed toward the midline
(e.g., genu valgus = knock-kneed)
ORTHOPAEDIC TERMS
Define the following terms:
Dislocation
P693
Total loss of congruity and contact
between articular surfaces of a joint
ORTHOPAEDIC TERMS
Define the following terms:
Subluxation
P693
Loss of congruity between articular
surfaces of a joint; articular contact still
remains
ORTHOPAEDIC TERMS
Define the following terms:
Arthroplasty
P694
Total joint replacement (most last 10 to
15 years)
ORTHOPAEDIC TERMS
Define the following terms:
Arthrodesis
P694
Joint fusion with removal of articular
surfaces
ORTHOPAEDIC TERMS
Define the following terms:
Osteotomy
P694
Cutting bone (usually wedge resection) to help realigning of joint surfaces
ORTHOPAEDIC TERMS
Define the following terms:
Non-union
P694
Failure of fractured bone ends to fuse
ORTHOPAEDIC TERMS
Define each of the
following:
Diaphysis
P694
Main shaft of long bone
ORTHOPAEDIC TERMS Define each of the following: Metaphysis P694
Flared end of long bone
ORTHOPAEDIC TERMS Define each of the following: Physis P694
Growth plate, found only in immature
bone
TRAUMA GENERAL PRINCIPLES Define extremity examination in fractured extremities. P694
- Observe entire extremity (e.g., open,
angulation, joint disruption) - Neurologic (sensation, movement)
- Vascular (e.g., pulses, cap refill)
TRAUMA GENERAL PRINCIPLES
Which x-rays should be
obtained?
P694
Two views (also joint above and below fracture)
TRAUMA GENERAL PRINCIPLES
How are fractures
described?
P694
- Skin status (open or closed)
- Bone (by thirds: proximal/middle/
distal) - Pattern of fracture (e.g., comminuted)
- Alignment (displacement, angulation,
rotation)
TRAUMA GENERAL PRINCIPLES How do you define the degree of angulation, displacement, or both? P694
Define lateral/medial/anterior/posterior
displacement and angulation of the distal
fragment(s) in relation to the proximal
bone
TRAUMA GENERAL PRINCIPLES
Identify each numbered
structure:
P695 (picture)
- Diaphysis
- Metaphysis
- Physis
- Epiphysis
FRACTURES Define the following patterns of fracture: Closed fracture P695
Intact skin over fracture/hematoma
FRACTURES Define the following patterns of fracture: Open fracture P695
Wound overlying fracture, through which
fracture fragments are in continuity with
outside environment; high risk of infection
(Note: Called “compound fracture” in
the past)
FRACTURES Define the following patterns of fracture: Simple fracture P695
One fracture line, two bone fragments
FRACTURES Define the following patterns of fracture: Comminuted fracture P695 (picture)
Results in more than two bone fragments;
a.k.a. fragmentation
RACTURES Define the following patterns of fracture: Segmental fracture P696 (picture)
Two complete fractures with a “segment”
in between
RACTURES Define the following patterns of fracture: Transverse fracture P696 (picture)
Fracture line perpendicular to long axis
of bone
RACTURES Define the following patterns of fracture: Oblique fracture P696 (picture)
Fracture line creates an oblique angle
with long axis of bone
RACTURES Define the following patterns of fracture: Spiral fracture P697 (picture)
Severe oblique fracture in which fracture
plane rotates along the long axis of bone;
caused by a twisting injury
RACTURES Define the following patterns of fracture: Longitudinal fracture P697
Fracture line parallel to long axis of bone
RACTURES Define the following patterns of fracture: Impacted fracture P697
Fracture resulting from compressive force;
end of bone is driven into contiguous
metaphyseal region without displacement
RACTURES Define the following patterns of fracture: Pathologic fracture P697
Fracture through abnormal bone (e.g.,
tumor-laden or osteoporotic bone)
RACTURES Define the following patterns of fracture: Stress fracture P697
Fracture in normal bone from cyclic
loading on bone
RACTURES Define the following patterns of fracture: Greenstick fracture P697 (picture)
Incomplete fracture in which cortex on
only one side is disrupted; seen in
children
RACTURES Define the following patterns of fracture: Torus fracture P698
Impaction injury in children in which
cortex is buckled but not disrupted
(a.k.a. buckle fracture)
RACTURES Define the following patterns of fracture: Avulsion fracture P698 (picture)
Fracture in which tendon is pulled from
bone, carrying with it a bone chip
RACTURES Define the following patterns of fracture: Periarticular fracture P698
Fracture close to but not involving the joint
RACTURES Define the following patterns of fracture: Intra-articular fracture P698
Fracture through the articular surface of a bone (usually requires ORIF)
RACTURES Define the following specific fractures: Colles’ fracture P698 (picture)
Distal radius fracture with dorsal
displacement and angulation, usually
from falling on an outstretched hand
(a common fracture!)
RACTURES Define the following specific fractures: Smith’s fracture P698
“Reverse Colles’ fracture”—distal radial
fracture with volar displacement and
angulation, usually from falling on the
dorsum of the hand (uncommon)
RACTURES Define the following specific fractures: Jones’ fracture P699
Fracture at the base of the fifth
metatarsal diaphysis
RACTURES Define the following specific fractures: Bennett’s fracture P699 (picture)
Fracture-dislocation of the base of the first metacarpal (thumb) with disruption of the carpometacarpal joint
RACTURES Define the following specific fractures: Boxer’s fracture P699 (picture)
Fracture of the metacarpal neck,
“classically” of the small finger
RACTURES Define the following specific fractures: Nightstick fracture P699
Ulnar fracture
RACTURES Define the following specific fractures: Clay shoveler’s avulsion fracture P699
Fracture of spinous process of C6–C7
RACTURES Define the following specific fractures: Hangman’s fracture P699
Fracture of the pedicles of C2
RACTURES Define the following specific fractures: Transcervical fracture P699
Fracture through the neck of the femur
RACTURES Define the following specific fractures: Tibial plateau fracture P700
Intra-articular fracture of the proximal tibia
the plateau is the flared proximal end
RACTURES Define the following specific fractures: Monteggia fracture P700
Fracture of the proximal third of the ulna
with dislocation of the radial head
RACTURES Define the following specific fractures: Galeazzi fracture P700
Fracture of the radius at the junction of
the middle and distal thirds accompanied
by disruption of the distal radioulnar joint
RACTURES Define the following specific fractures: Tibial “plateau” fracture P700 (picture)
Proximal tibial fracture
RACTURES Define the following specific fractures: “Pilon” fracture P700 (picture)
Distal tibial fracture
RACTURES Define the following specific fractures: Pott’s fracture P700
Fracture of distal fibula
RACTURES Define the following specific fractures: Pott’s disease P700
Tuberculosis of the spine
ORTHOPAEDIC TRAUMA
What are the major
orthopaedic emergencies?
P701
- Open fractures/dislocations
- Vascular injuries (e.g., knee
dislocation) - Compartment syndromes
- Neural compromise, especially spinal
injury - Osteomyelitis/septic arthritis; acute,
i.e., when aspiration is indicated - Hip dislocations—require immediate
reduction or patient will develop avascular
necrosis; “reduce on the x-ray table” - Exsanguinating pelvic fracture (binder,
external fixator)
ORTHOPAEDIC TRAUMA
What is the main risk when
dealing with an open fracture?
P701
Infection
ORTHOPAEDIC TRAUMA
Which fracture has the
highest mortality?
P701
Pelvic fracture (up to 50% with open pelvic fractures)
ORTHOPAEDIC TRAUMA
What factors determine the
extent of injury (3)?
P701
1. Age: suggests susceptible point in musculoskeletal system: Child—growth plate Adolescent—ligaments Elderly—metaphyseal bone 2. Direction of forces 3. Magnitude of forces
ORTHOPAEDIC TRAUMA What is the acronym for indications for OPEN reduction? P701
“NO CAST”:
Nonunion
Open fracture
Compromise of blood supply Articular surface malalignment Salter-Harris grade III, IV fracture Trauma patients who need early ambulation
ORTHOPAEDIC TRAUMA Define open fractures by Gustilo-Anderson classification: Grade I? P701
<1-cm laceration
ORTHOPAEDIC TRAUMA Define open fractures by Gustilo-Anderson classification: Grade II? P701
> 1 cm, minimal soft tissue damage
ORTHOPAEDIC TRAUMA Define open fractures by Gustilo-Anderson classification: Grade IIIA? P702
Open fracture with massive tissue
devitalization/loss, contamination
ORTHOPAEDIC TRAUMA Define open fractures by Gustilo-Anderson classification: Grade IIIB? P702
Open fracture with massive tissue
devitalization/loss and extensive
periosteal stripping, contamination,
inadequate tissue coverage
ORTHOPAEDIC TRAUMA Define open fractures by Gustilo-Anderson classification: Grade IIIC? P702
Open fracture with major vascular injury
requiring repair
ORTHOPAEDIC TRAUMA
What structures are at risk
with a humeral fracture?
P702
Radial nerve, brachial artery
ORTHOPAEDIC TRAUMA What must be done when both forearm bones are broken? P702
Because precise movements are needed,
open reduction and internal fixation are
musts
ORTHOPAEDIC TRAUMA
How have femoral fractures
been repaired traditionally?
P702
Traction for 4 to 6 weeks
ORTHOPAEDIC TRAUMA
What is the newer technique?
P702
Intramedullary rod placement
ORTHOPAEDIC TRAUMA
What are the advantages?
P702
Nearly immediate mobility with
decreased morbidity/mortality
ORTHOPAEDIC TRAUMA
What is the chief concern
following tibial fractures?
P702
Recognition of associated compartment
syndrome
ORTHOPAEDIC TRAUMA
What is suggested by pain in
the anatomic snuff-box?
P702
Fracture of scaphoid bone (a.k.a.
navicular fracture)
ORTHOPAEDIC TRAUMA What is the most common cause of a “pathologic” fracture in adults? P702
Osteoporosis
ORTHOPAEDIC TRAUMA COMPARTMENT SYNDROME What is acute compartment syndrome? P703
Increased pressure within an osteofascial
compartment that can lead to ischemic
necrosis
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
How is it diagnosed?
P703
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)
ORTHOPAEDIC TRAUMA
COMPARTMENT SYNDROME
What are the causes?
P703
Fractures, vascular compromise,
reperfusion injury, compressive dressings;
can occur after any musculoskeletal
injury
ORTHOPAEDIC TRAUMA COMPARTMENT SYNDROME What are common causes of forearm compartment syndrome? P703
Supracondylar humerus fracture, brachial
artery injury, radius/ulna fracture, crush
injury
ORTHOPAEDIC TRAUMA COMPARTMENT SYNDROME What is Volkmann’s contracture? P703
Final sequela of forearm compartment
syndrome; contracture of the forearm
flexors from replacement of dead muscle
with fibrous tissue
ORTHOPAEDIC TRAUMA COMPARTMENT SYNDROME What is the most common site of compartment syndrome? P703
Calf (four compartments: anterior,
lateral, deep posterior, superficial
posterior compartments)