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Finals > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

How should acute osteomyelitis be managed?

A
  • Analgesia
  • Rest and splintage
  • Fluclox and Benpen for 4-6 weeks
  • Surgery
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2
Q

How can chronic osteomyelitis be managed?

A
  • Long term antibiotics (local: gentamicin cement or systematic)
  • Surgery
  • ?Amputation
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3
Q

How can acute septic arthritis be managed?

A
  • Supportive
  • Flucloxacillin (3-4 weeks)
  • Surgical drainage and lavage
  • Infected joint replacements (one or two stages)
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4
Q

How does compartment syndrome present?

A
  • PAIN
  • Pulselessness
  • Pale
  • Perishingly cold
  • Paralysed
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5
Q

How should compartment syndrome be managed initially?

A
  • Keep limb at neutral level
  • Oxygen if needed
  • Stabilise blood pressure
  • Remove splints, casts and dressings
  • Analgesia
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6
Q

What is the definitive management for compartment syndrome?

A

-Emergency fasciotomy

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7
Q

What are the complications of compartment syndrome?

A
  • Acute limb ischaemia
  • Rhabdomyolysis
  • Hyperkalaemia
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8
Q

How can an open fracture be managed?

A
  • Realignment and splinting
  • Broad spectrum antibiotics
  • Tetanus vaccine
  • Debridment
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9
Q

Which tests are used to diagnose carpal tunnel syndrome?

A
  • Phalen (flexing the wrist for 60 seconds)

- Tinels (tapping lightly over the median nerve)

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10
Q

How can carpal tunnel syndrome be managed?

A
  • May resolve on its on
  • Splint
  • NSAIDs
  • Corticosteroids
  • Surgical release of the nerve
  • Physiotherapy
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11
Q

Which nerve is affected in cubital tunnel syndrome?

A

Ulnar nerve

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12
Q

How does a cubital tunnel syndrome present?

A
  • Wasting and weakness of the small muscles of the hand
  • Clawing of the ring and little finger
  • Numbness and tingling along the little finger
  • Pain and tenderness at the cubital tunnel
  • Tinels sign and elbow flexion test
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13
Q

How can cubital tunnel syndrome be managed?

A
  • Physiotherapy
  • Splinting
  • Painkillers
  • Surgical decompression and surgical transposition
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14
Q

What is the most common type of shoulder dislocation?

A

Anterior

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15
Q

How can shoulder dislocations be managed?

A
  • Reduction, immobilisation and rehabilitation
  • Assess neurovascular status
  • Broad arm sling
  • Physiotherapy
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16
Q

What is a Colle’s fracture?

A

An extra-articular fracture of the distal radius with dorsal angulation and displacement

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17
Q

What is a Smith’s fracture?

A

An extra-articular fracture of the distal radius with volar angulation

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18
Q

What is a Barton’s fracture?

A

An intra-articular fracture of the distal radius with associated dislocation of the radio-carpal joint

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19
Q

How can distal radial fractures be managed?

A
  • Traction and manipulation under anaesthesia
  • ORIF with K wire fixation for displaced or unstable fractures
  • Below elbow backslab cast
  • Physiotherapy
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20
Q

Which nerve can be damaged in humeral shaft fractures?

A

Radial nerve

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21
Q

How can humeral shaft fractures be managed?

A
  • Realignment
  • Humeral brace (high elbow casts for distal fractures)
  • ORIF
  • Intramedullary nails for pathological fractures
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22
Q

Which neurovascular structures can be damaged in proximal humeral fractures?

A
  • Axillary nerve

- Circumflex vessels

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23
Q

How can proximal humeral fractures be managed?

A
  • Early mobilisation
  • Pendular exercises
  • Polysling
  • Surgical management: displaced, open or NV compromised
24
Q

How does an achilles tendon rupture present?

A
  • Sudden onset severe pain
  • Popping sound
  • Loss of plantarflexion
25
Q

How can an achilles tendon rupture be managed?

A
  • Analgesia
  • Ankle splinted in plaster
  • Surgical tendon repair
26
Q

How can ankle lateral ligament injury be managed?

A
  • Rest, ice, compression and elevation
  • NSAIDs
  • Surgery
27
Q

How can an anterior cruciate ligament tear be managed?

A
  • X-ray and MRI
  • Rest, ice, compression and elevation
  • Physio to strengthen the quads to support the knee
  • Surgical reconstruction
28
Q

How can MCL tears be managed?

A
  • Grade 1: RICE, analgesia and strength training
  • Grade 2: Analgesia, knee brace and weight bearing
  • Grade 3: knee brace and crutches
29
Q

How does a posterior dislocation of the hip present?

A

A shortened and internally rotated hip which is flexed and adducted

30
Q

How can a dislocation of the hip be managed?

A
  • Analgesia

- Reduction under general anaesthetic`

31
Q

How does an anterior dislocation of the hip present?

A
  • Pain in the hip
  • Inability to weight bear or adduct the leg
  • Externally rotated, abducted and extended
32
Q

What is a central dislocation of the hip?

A

The head of the femur is driven through the acetabular floor

33
Q

How can meniscal tears be managed?

A
  • RICE
  • Small tears will heal in their own
  • Larger tears may need arthroscopic surgery
34
Q

How can neck of femur fractures be managed?

A
  • Displaced subcapital: hemiarthroplasty
  • Inter-trochanteric: dynamic hip screw
  • Intra-capsular: (non-displaced) cannulated hip screws
  • Displaced intra-capsular: arthroplasty
  • Sub-trochanteric: intramedullary nail
35
Q

How can pelvic fractures be managed?

A
  • Primary survey
  • Resuscitation
  • Pelvic binder
  • Surgical or conservative management
36
Q

How does subacromial impingement present?

A
  • Progressive pain in the anterior superior shoulder
  • Pain exacerbated by abduction
  • Weakness and stiffness
37
Q

How can subacromial impingement be managed?

A
  • NSAIDs
  • Physiotherapy
  • Steroid injections
  • Injections
38
Q

How does a frozen shoulder present (adhesive capsulitis)?

A
  • Deep pain
  • Joint stiffness
  • Loss of arm swing
  • External rotation and flexion most affected
39
Q

How can a frozen shoulder be managed?

A

-Analgesia
-Steroid injections
-Joint manipulation under
GA
-Surgical release of the glenohumeral joint capsule

40
Q

How do rotator cuff tears present?

A
  • Lateral pain
  • Inability to abduct the arm above 90 degrees
  • Tenderness over the greater tuberosity
41
Q

How can rotator cuff tears be managed?

A
  • Analgesia
  • Physiotherapy
  • Steroid injections
  • Surgical repair
42
Q

How can elbow dislocations be managed?

A
  • Closed reduction
  • Elbow backslab
  • Open fixation (fractures or NV compromise)
43
Q

How does tennis elbow present?

A
  • Pain and tenderness over the lateral epicondyle of the humerus
  • Pain on resisted dorsiflexion of the wrist
44
Q

How does Golfer’s elbow present?

A
  • Pain and tenderness at the medial epicondyle

- Aggravated by wrist flexion and pronation

45
Q

How can Tennis and Golfer’s elbow be managed?

A
  • Modify activites
  • Steroid injection
  • Orthotics
  • Physiotherapy
  • Surgery (if refractory to a long period of conservative management)
46
Q

How does Dupuytren’s disease present?

A
  • Painless

- Loss of finger extension

47
Q

How can Dupuytren’s disease be managed?

A
  • Observe
  • NO splints
  • Radiotherapy
  • Partial fasciectomy
  • Collagenase
48
Q

How does trigger finger present?

A
  • Clicking sensation with movement
  • Lump in palm
  • Locking
49
Q

How can trigger finger be managed?

A
  • Splintage
  • Steroid
  • Percutaneous release
  • Open surgery
50
Q

How does De Quervain’s syndrome present?

A
  • Pain localised to radial side of the wrist

- Aggravated by movement of the thumb

51
Q

How can De Quervain’s syndrome be managed?

A
  • Splints
  • Steroid injection
  • Decompression
52
Q

How does a radial nerve injury present?

A
  • Wrist drop

- Sensory loss to the dorsal surface of the lateral three digits

53
Q

How does a hand flexor tendon injury present?

A

Loss of active flexion strength

54
Q

How should scaphoid fractures be managed?

A
  • Undisplaced: immobilisation
  • Displaced: operatively
  • All fractures of the proximal pole should be surgically fixed
55
Q

How do osteosarcomas show on X-rays?

A
  • Codman’s triangle

- Sunburst pattern

56
Q

How do Ewing’s sarcomas show on x-rays?

A
  • Paediatric
  • Lytic lesion with periosteal reactions
  • Onion skin appearance
57
Q

How do chondrosarcomas show on x-rays?

A
  • Lytic lesions
  • Calcification
  • Cortical remodelling
  • Endosteal scalloping

Finals (18 decks)

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