Orthopaedics Flashcards
what is osteosarcoma
most common bone cancer in teenage males
warm painful swelling in the knee
has a ‘sunburst’ appearance in the x ray
what is Ewings sarcoma
it presents as painful warm growing swelling
patient will have anaemia
‘onion skin’ on x ray
what is Chondrosarcoma
Chondrosarcoma is cartilaginous malignancy at occurs in older patients (>40) with pain and a lump. Many of these arise from previous chondromas that have undergone malignant change. X-ray shows a lytic lesion with ‘fluffy popcorn calcification’.
what is Osteochondritis dissecans
Osteochondritis dissecans is a condition where the blood supply of bone is interrupted, leading to bone and cartilage detaching from the area and being able to move freely in the joint space. It commonly occurs in young adults at the knee, elbow and ankle.
What is the Ottawa rule
It is an x-ray requirement for malleolar pain
- If there is bone tenderness at the posterior lateral malleolus
- Bone tenderness, at the posterior medial malleolus
- Oh, if the patient is unable to bear weight for four steps
what does the T score show from the DEXA scan
if the score is less than -0.2 = osteopenia (less severe osteoporosis)
less than -0.25 then it is osteoporosis
what is a risk factor for osteoporosis
taking steroids for a long time
menopause
what is osteoporosis characterised by
It is characterised by low bone density without actually changing the formation of the bone having less oestrogen levels can cause pores in the bone which make it weaker.
what is the most common fracture in children
Supracondylar fracture, there are three different types of it
- This is when the fracture is undisplaced
- The fracture has moved back slightly
- This is when the fracture is displaced
What is the most common complication of a supracondylar fracture in children
They can be a disruption to the artery or nervous apply
The most common one being at the median artery
What is a greenstick fracture?
It is a type of fracture that is seen in younger children, especially in the radius and ulna.
It is when the radius or the ulna bone does not completely break instead it bends because children bones are more malleable - harder to snap in half.
What is a Monteggia fracture?
It is the fracture of the ulna bone which also causes displacement of the Radiohead from the socket. It is the most common in children.
What is a Monteggia fracture?
It is the fracture of the ulna bone which also causes displacement of the Radial head from the socket. It is the most common in children.
What is a bakers cyst?
Most common cause of swelling behind the knee, common in osteoarthritis
hard
what are osteophytes
This is seen in osteoarthritis and is when there is abnormal bone growth
and his bone is around to help and support and these bones start producing more fluid which then becomes a cyst which is called a bakers cyst which is found behind the knee.
What is a popliteal aneurysm?
This is when does an aneurysm in the popliteal artery, and this will produce a pulsating compressible lump under the skin
what is a galizzia fracture
This is a fracture of the radius and dislocation of the distal ulna, or a fracture of both bones
What is a Smith’s fracture?
This is a radial fracture that moves towards the front
What is a baton fracture/knightstick fracture
- This is a fracture that goes through the joint
ulna fracture
What is a colles fracture?
This is a radial fracture that moves backwards
What is the management of a displaced Coles fracture?
Close reduction, immobilise with wrist splint
In which population is a colles fracture, most commonly seen
It is most commonly seen in elderly patients to the wrist fracture
Why is carpal tunnel syndrome worse at night
The increase production of ADH in the night to Prevent urination during the night causes water retention, and this can cause a pressure on the nerves, which makes carpal tunnel syndrome worse
klumpes palsy what is it?
It is clawhand due to damage at C8 and T1 brachioplexus
What is the most common side effect of bisphosphate used for
They can cause stomach issues hence why they are taken with a PPI. The best way to take a bisphosphonate is on an empty stomach first thing in the morning and sit up for half an hour.
What nerve is most commonly damaged in a mid shaft humerus fracture?
The radial nerve is most likely to be damaged, causing risk drop
What is a waiters tip?
Also, known as Erbs palsy, it is the paralysis of the brachial plexus at C5 and C6, and is when the arm is internally rotated it is commonly associated with shoulder dystocia
What criteria is used for the classification of a intracapsular fracture?
Garden classification
What is the complication of an intracapsular fracture of the neck of femur?
It can affect the deep, femoral artery and affect blood supply to the proximal part of the bone
This can cause two complications
Non-union, this is when the bone does not heal and cannot join back to the hip socket
Avascular necrosis this is when even if the bone heals it will have replaced and changed in shape and so therefore can no longer fit with the hip socket
What is the management of an intracapsular fracture in a young person?
Use screws or a dynamic hip screw
What is the management of a intracapsular fracture in an older patient?
Because these are harder to heal, it is easier to do a partial or total hip replacement the total hip replacement is done in a patient who is fit and healthy
What is the management for an intertrochanteric fracture?
Use a dynamic hip screw, and sometimes a rod can be used
What is a management for a subtrochanteric fracture?
Intramedullary nail
What is the management of a extracapsular fracture?
Dynamic hip, screw
What is the garden of classification?
- undisplaced partial fracture
- undisplaced but full fracture
- displaced fracture partial displacement
- full displaced fracture
For the undisplaced fracture do fixation and replacement, but for a displaced fracture do full replacement
what is a common complication of a hip replacement? causes shortness of breath and a red petechiae rash on the chest?
fat embolism
