Orthopaedics Flashcards
Complications due to a fracture:
Rhabdomyolysis, Sepsis, VTE
Fracture General Management:
The 4 R’s:
- Resuscitation
- Reduction
- Restriction
- Rehabilitation
Factors which delay fracture healing?
Diabetes (poor blood supply)
Vascular Insufficiency
Malnutrition
Disorders of Vit.D and calcium or phosphate metabolism
**Think of things that affect vascualture/bone metabolism**
6 P’s of acute peripheral ischaemia
The six Ps of acute ischemia include
pain
pallor
poikilothermia
pulselessness
paresthesia
paralysis
Gas gangrene is caused by which organism?
Clostiridum Perfringens
Surgical procedure for cauda quina (contraindicated in metastatic disease):
Laminectomy
Type 1 necrotising fasciitis is a ____ infection.
Polymicrobial
Type 2 necrotising fasciitis is a _____ infection.
Monomicrobial
(usually Strep A infection)
Which intracompartemental pressure is diagnostic of compatment syndrome?
> 40 mmHg
Colles Fracture is a ____ displacement of the distal radius.
Dorsal
Hand signs associated with osteoarthritis?
Heberdens (DIP) Bouchards (PIP) Remember Emily’s fingers have Heberdens
Transient synovitis is generally preceded by a _____ 1-2 weeks before the onset of pain and limp.
Viral infection (particularly upper respiratory tract infections)
Microscopy, culture and sensitivity of the joint aspirate will distinguish between TS and septic arthritis, as bacteria within the joint space confirms septic arthritis.
Transient synovitis (sin-oh-vie-tis), commonly called irritable hip, is the most common cause of limping in children
Perthes disease is avascular necrosis of the femoral head in children aged ____.
Ischaemia in Perthes disease presents with gradual onset limp and hip pain. Pain can also be referred to the knee. Pain from transient synovitis would be similar, but would only last around ____ weeks; pain persisting for ____ weeks should raise suspicion for Perthes disease.
4-8 yrs
2 weeks
>4 weeks
Osteoid Osteoma is a benign tumour in children that is classicaally relieved by ____.
NSAIDs
- and do not need escalating analgesia
Ewing’s is the second most common malignant bone tumor in children, comprising 10-15% of childhood bone cancers. Ewing’s tumors have characteristic _____ cells
small round blue
____ is the most common type of bone tumour in children and commonly occurs in the bones around the knee, as it often originates from the ____.
Osteosarcoma
Metaphysis
____ and ____ are the most common malignancies of bone tissues in children. Add
Osteosarcoma and Ewing’s sarcoma
Osteosarcoma, the more common of the two types, usually presents in bones around the knee. Ewing’s sarcoma may affect bones of the pelvis, thigh, upper arm, or ribs.
SUFE often presents with ____ pain alone.
On flexing the knee the childs hip will _____
Knee
externally rotate (called obligatory external rotation)
Osteogenesis imperfecta is a genetic disorder varying in severity characterised by ____ formation in bones, leading to fragile bones which are prone to fractures. It is also commonly associated with eye, hearing and dental abnormalities.
Mnemonic - ___ :
Inadequate collagen
BITE
B = bones
I = eyes
T = teeth
E = ears
Menisci are primarily made up of type ___ collagen. There is a medial and lateral meniscus in the knee.
2
_____ classification is used to determine severity of open fracture IN THEATRE following debridement.
Gustilo-Anderson
Compartment syndrome 3 Pains:
PAIN- out of proportion
PAIN - not relieved by storng opiates
PAIN- on passive flexion
NB - 5Ps of peripheral vascular compromise is a late sign!
Pelvic Sphlanchnic Nerves ____ - ____ are responsible for the ____ innervation of the bladder. They thus are responsible for ____ and detrusor contraction, but also provide involuntary control to the ____ urethral sphincter.
S2-S4 (pelvic nerve)
Parasympathetic
Urge reflex
External
The most important adage to remember for the surgical management in traumatic orthopaedic complaints is ‘____– ___– ____’.
“Reduce - Hold - Rehabilitate “
