Orthopaedics Flashcards

1
Q

How should acute osteomyelitis be managed?

A
  • Analgesia
  • Rest and splintage
  • Fluclox and Benpen for 4-6 weeks
  • Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can chronic osteomyelitis be managed?

A
  • Long term antibiotics (local: gentamicin cement or systematic)
  • Surgery
  • ?Amputation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does compartment syndrome present?

A
  • PAIN
  • Pulselessness
  • Pale
  • Perishingly cold
  • Paralysed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the definitive management for compartment syndrome?

A

-Emergency fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the complications of compartment syndrome?

A
  • Acute limb ischaemia
  • Rhabdomyolysis
  • Hyperkalaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can an open fracture be managed?

A
  • Realignment and splinting
  • Broad spectrum antibiotics
  • Tetanus vaccine
  • Debridment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can carpal tunnel syndrome be managed?

A
  • May resolve on its on
  • Splint
  • NSAIDs
  • Corticosteroids
  • Surgical release of the nerve
  • Physiotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which nerve is affected in cubital tunnel syndrome?

A

Ulnar nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can cubital tunnel syndrome be managed?

A
  • Physiotherapy
  • Splinting
  • Painkillers
  • Surgical decompression and surgical transposition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common type of shoulder dislocation?

A

Anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can shoulder dislocations be managed?

A
  • Reduction, immobilisation and rehabilitation
  • Assess neurovascular status
  • Broad arm sling
  • Physiotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a Colle’s fracture?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a Smith’s fracture?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which nerve can be damaged in humeral shaft fractures?

A

Radial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which neurovascular structures can be damaged in proximal humeral fractures?

A
  • Axillary nerve

- Circumflex vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How can an achilles tendon rupture be managed?
- Analgesia - Ankle splinted in plaster - Surgical tendon repair
26
How can ankle lateral ligament injury be managed?
- Rest, ice, compression and elevation - NSAIDs - Surgery
27
How can an anterior cruciate ligament tear be managed?
- X-ray and MRI - Rest, ice, compression and elevation - Physio to strengthen the quads to support the knee - Surgical reconstruction
28
How can MCL tears be managed?
- Grade 1: RICE, analgesia and strength training - Grade 2: Analgesia, knee brace and weight bearing - Grade 3: knee brace and crutches
29
How does a posterior dislocation of the hip present?
A shortened and internally rotated hip which is flexed and adducted
30
How can a dislocation of the hip be managed?
- Analgesia | - Reduction under general anaesthetic`
31
How does an anterior dislocation of the hip present?
- Pain in the hip - Inability to weight bear or adduct the leg - Externally rotated, abducted and extended
32
What is a central dislocation of the hip?
The head of the femur is driven through the acetabular floor
33
How can meniscal tears be managed?
- RICE - Small tears will heal in their own - Larger tears may need arthroscopic surgery
34
How can neck of femur fractures be managed?
- Displaced subcapital: hemiarthroplasty - Inter-trochanteric: dynamic hip screw - Intra-capsular: (non-displaced) cannulated hip screws - Displaced intra-capsular: arthroplasty - Sub-trochanteric: intramedullary nail
35
How can pelvic fractures be managed?
- Primary survey - Resuscitation - Pelvic binder - Surgical or conservative management
36
How does subacromial impingement present?
- Progressive pain in the anterior superior shoulder - Pain exacerbated by abduction - Weakness and stiffness
37
How can subacromial impingement be managed?
- NSAIDs - Physiotherapy - Steroid injections - Injections
38
How does a frozen shoulder present (adhesive capsulitis)?
- Deep pain - Joint stiffness - Loss of arm swing - External rotation and flexion most affected
39
How can a frozen shoulder be managed?
-Analgesia -Steroid injections -Joint manipulation under GA -Surgical release of the glenohumeral joint capsule
40
How do rotator cuff tears present?
- Lateral pain - Inability to abduct the arm above 90 degrees - Tenderness over the greater tuberosity
41
How can rotator cuff tears be managed?
- Analgesia - Physiotherapy - Steroid injections - Surgical repair
42
How can elbow dislocations be managed?
- Closed reduction - Elbow backslab - Open fixation (fractures or NV compromise)
43
How does tennis elbow present?
- Pain and tenderness over the lateral epicondyle of the humerus - Pain on resisted dorsiflexion of the wrist
44
How does Golfer's elbow present?
- Pain and tenderness at the medial epicondyle | - Aggravated by wrist flexion and pronation
45
How can Tennis and Golfer's elbow be managed?
- Modify activites - Steroid injection - Orthotics - Physiotherapy - Surgery (if refractory to a long period of conservative management)
46
How does Dupuytren's disease present?
- Painless | - Loss of finger extension
47
How can Dupuytren's disease be managed?
- Observe - NO splints - Radiotherapy - Partial fasciectomy - Collagenase
48
How does trigger finger present?
- Clicking sensation with movement - Lump in palm - Locking
49
How can trigger finger be managed?
- Splintage - Steroid - Percutaneous release - Open surgery
50
How does De Quervain's syndrome present?
- Pain localised to radial side of the wrist | - Aggravated by movement of the thumb
51
How can De Quervain's syndrome be managed?
- Splints - Steroid injection - Decompression
52
How does a radial nerve injury present?
- Wrist drop | - Sensory loss to the dorsal surface of the lateral three digits
53
How does a hand flexor tendon injury present?
Loss of active flexion strength
54
How should scaphoid fractures be managed?
- Undisplaced: immobilisation - Displaced: operatively - All fractures of the proximal pole should be surgically fixed
55
How do osteosarcomas show on X-rays?
- Codman's triangle | - Sunburst pattern
56
How do Ewing's sarcomas show on x-rays?
- Paediatric - Lytic lesion with periosteal reactions - Onion skin appearance
57
How do chondrosarcomas show on x-rays?
- Lytic lesions - Calcification - Cortical remodelling - Endosteal scalloping