Orthopaedics Flashcards
Gas gangrene pathogen
Clostridium perfringens
intracapsular fracture grading system name
Garden Classification
Garden Classification breakdown
I incomplete #
II complete #, non-displacement
III complete #, partial displacement
III complete #, full displacement
Garden Classification and treatment indication
I & II = ORIF + cannulated screws III & IV = younger <55: ORIF + cannulated screws 75-55: THR >75: hemiarthroplasty
extra capsular NOF management
ORIF with DHS
female athletic triad
osteoporosis
eating disorders
amenorrhoea
> stress fractures
ulnar nerve injury presentation
claw hand
weakness in abduction / adduction of fingers
sensory loss over 5th digit
ulnar paradox
greater clawing of hand in ulnar nerve injury at wrist compared to elbow (higher injuries > injury of flexor digitorum profundus)
radial nerve injury presentation
wrist drop ie. loss of extension of wrist, fingers and thumb
weakness over 1st dorsal interosseous muscle
cauda equina muscular weakness presentation
foot drop
loss of perianal reflex
fat embolism presentation
TRIAD
hypoxaemia
petechial rash
neurological changes (confusion)
Cozen’s test
flex wrist to 90 degrees, make fist, deviate forearm to radial side => pain over lat epicondyle
ie. pain during resisted extension of wrist
= sign of tennis elbow (lateral epicondylitis)
Abx that can cause Achilles tendonitits / tendon rupture
ciprofloxacin
Osteoporosis diagnostic / cut off T score
-2.5
osteoporosis screening investigations
Calcium, PTH, vit D, bone turnover markers, TFTs, LFTs
urine electrophoresis
plasma electrophoresis
first line treatment of osteoporosis
alendronic acid
calcium
vitamin d supplements
osteoporosis treatment with swallowing difficulty
Denosumab
most common causes of osteolytic bone mets in an adult
lung breast thyroid kideny colon
most common causes of osteoblastic mets in an adult
prostate
breast
primary malignancies that result in mixed bone mets
breast
prostate
lymphoma
Myeloma presentation on XRay
lytic destructive bony lesions
what muscle is most likely affected in radial shaft fractures
brachioradialis ie. elbow flexion
due to innervation of radial n.
(close to diaphysis of radius - common site of #)
most likely # after throwing a punch
5th metacarpal neck
“boxers punch”
nerve likely affected following tibial shaft #
sural n.
= prov innervation to posterolateral middle 1/3 of leg and lateral foot
deep peroneal n.
= prov innervation to 1st and 2nd toes
Achilles tendon rupture causes
sports (running)
freq use of floroquinolones eg. ciprofloxacin
What is the Nottingham Fracture Score and what does it quantify?
score quantifying the % 30 day mortality of patients admitted with a hip fracture
age (<66 = 0, 66-85 = 3, >85 = 4) sex M = 1 admission Hb < 9 = 1 admission MMTS < 6/10 = 1 institution living YES = 1 co-morbidities >1 = 1 active malignancy in past 20 years YES = 1
Open fracture classification
Gustillo Anderson Classification
Gustillo Type I
< 1cm open fracture + clean
Gustillo Type II
1-10cm open fracture + clean
Gustillo Type III A
> 10cm open fracture high energy impact extensive soft tissue damage BUT with adequate tissue for flap coverage no NV impairment farm injuries
Gustillo Type III B
> 10cm open fracture
extensive periosteal stripping
req. soft tissue coverage
Gustillo Type III C
> 10cm open fracture
vascular injury
req. urgent vascular repair regardless of observed soft tissue damage
