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UCPEX > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

Indication to manipulate Colles

A

> 20 degrees angulation
Shortening >5mm
Displacement >2/3 radius

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2
Q

Clavicle MOI and resulting fracture

A

Force through acromion - middle 1/3
Force from above - lateral
Inferior force - comminuted
Posterior force single fracture

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3
Q

Referral for clavicle fracture

A

> 2cm shortening
100% displaced

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4
Q

Shoulder dislocation position

A

Anterior - abduction, external rotation

Posterior - flexion, internal rotation

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5
Q

Most common osteoporotic fractures

A
  1. distal radius
  2. vertebral
  3. proximal humerus
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6
Q

MOI brachial plexus

A

Traction
Compression
Direct blow to supraclavicular fossa

Stretching > neuropraxia
Rupture > full/partial tear - roots still connected to spinal cord
Avulsion > Complete detachment of root from spinal cord

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7
Q

Patterns of brachial plexus injuries

A

Erb’s palsy - C5-6 +/- C7
Klumpke’s palsy C8-T1 +/- C7
Total palsy - C5-T1
Horner’s syndrome - sympathetic chain C8-T1 root avulsion

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8
Q

Bauman’s angle

A

Supracondylar fracture - coronal plain deformity:

Angle between longitudinal humeral shaft and lateral condyle physis
Normal 70-75 deg

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9
Q

Nerve at risk in Monteggia fracture/dislocation

A

Posterior interosseous nerve

Weak finger extension
Weak thumb extension
Wrist extension > radial deviation

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10
Q

Galeazzi fracture - clues to DRUJ injury

A

Widening of DRUJ
Fracture base of ulna styloid
Dislocation/subluxation of ulna on lateral
>5mm shortening of radius compared to ulna

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11
Q

4 stages of carpal disruption: Mayfield classification

A
  1. Scapholunate dissociation
  2. Lunocapitate disruption
  3. Lunotriquetral disruption = perilunate dislocation
  4. Lunate dislocation + median nerve compression
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12
Q

Associated fracture with perilunate dislocation

A

Scaphoid in 61%

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13
Q

Tendons involved in De Quervains tenosynovitis

A

EPB
APL

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14
Q

TFCC articulation

A

Ulna + triquetrum
Radius + lunate

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15
Q

Signs of TFCC injury

A

Pain between ulnar styloid + pisiform/FCU - Ulna fovea sign
Pain on supination lift test
Decreased wrist power, decreased forearm rotation
Prominence of ulna head

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16
Q

Canadian C spine rules

A

> 65, dangerous mechanism, paraesthesia

Low risk factors - sitting, ambulatory, delayed onset pain, no midline tenderness, low speed MVA

Check active rotation 45 deg

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17
Q

Young and Burgess classification of pelvic ring fractures

A

Anteroposterior compression - open book
Lateral compression - windswept pelvis
Vertical shear - Malgaigne fracture, bucket handle fracture
Combination

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18
Q

Avulsion fractures of pelvis, muscles attach:

Iliac crest
ASIS
AIIS
GT
LT
Ischial tuberosity
Pubic symphysis

A

Iliac crest - abdominal wall
ASIS - Sartorius
AIIS - rectus femoris
GT - glute medius and minimus
LT - Iliopsoas
IT - hamstrings
pubic symphysis - adductors

19
Q

Garden classification for intraarticular NOF#

A

I - valgus impacted
II - undisplaced complete fracture
III - partially displaced
IV - fully displaced

20
Q

Risk factors for SUFE

A

Obesity
Adolescents - 10-16
Male
African American, Pasifika, Latino
Prior radiation to area

21
Q

Symptoms and signs of SUFE

A

Groin pain
Knee pain
Limp - trendelenburg/waddling gait

Limited internal rotation
Drehmann sign - external rotation with passive flexion of hip
Thigh atrophy

22
Q

Estimated for closed and open femur and tibia fractures

A

Closed femur 1-1.5L
Open femur 2-3L
Closed tibia - 0.5-1L
Open tibia 1-2L

23
Q

Ottawa knee rule

A

Xray if any of:

Age >55
Isolated patella tenderness
Tenderness at fibula head
Unable to flex to 90 deg
Unable to weight bear >4 steps

24
Q

Associated soft tissue injuries in tibial plateau fracture

A

ACL rupture
Lateral meniscal injury

25
Q

Medial collateral ligament tears are associated with what other ligament tear?

A

ACL

26
Q

Risk factors for Osgood Schlatter’s

A

Girls 8-12
Boys 12-15
Atheletic - jumping sports/sprinting

27
Q

Oestern + Tscherne classification for soft tissue injury in closed fractures

A

0 - minimal soft tissue injury
1 - Superficial contusion/abrasion, simple fractures
2 - Deep abrasions, muscle/skin contusions, direct trauma, impending compartment syndrome
3 - Excessive skin contusion, muscle destruction, crushed skin, subcutaneous degloving, acute compartment syndrome, rupture of major blood vessel/nerve

28
Q

Risk factors for Achilles tendon rupture

A

“Weekend warrior”
Steroid injections
Fluoroquinolone antibiotics

29
Q

Risks for compartment syndrome

A

Fractures/crush injuries to limb
Circumferential 3rd degree burns
Limb reperfusion injury
DVT
Cast, splints, constrictive dressings
Male
<35

30
Q

Symptoms of compartment syndrome

A

6 P’s
Pain
Pallor
Pulselessness
Poikylothermia
Paralysis
Paraesthesia

31
Q

Intracompartment reading for compartment syndrome

A

Normal 0-4mmHg
With exertion - up to 10mmHg
Acute compartment syndrome: >30mmHg

32
Q

Ottawa ankle rules

A

Tenderness on:
Posterior edge/tip distal 6cm lateral mall
Posterior edge/tip distal 6cm medial mall
Base of 5th MT
Navicular
Inability to bear weight >4 steps

33
Q

Ankle injury in pronation + external rotation

A

Medial malleolar, consider Maisonneuve

34
Q

Ankle injury in inversion and external rotation

A

Distal fibular

35
Q

Ankle injury in abduction/forced eversion

A

Deltoid ligament

36
Q

Ankle injury in adduction

A

LCL tear/tip of fibula avulsion

37
Q

Ankle injury with inversion on plantar flexed foot

A

Lateral ligament complex sprain

38
Q

Conservative management of calcaneus fractures

A

<1cm extraarticular fracture, <2mm displacement, intact Achilles

Sanders I - non displaced posterior facet

Anterior process fracture <25% calcaneocuboid joint

Non smoker, non diabetic, no PVD

39
Q

Bohler’s angle
Gissane’s angle

A

Bohler’s - normal 20-40
Reduced = collapse of posterior facet

Gissane’s angle - normal 120-145
Increased = collapse of posterior facet

40
Q

Snowboarder’s fracture

A

Lateral process of talus
Dorsiflexion, inversion

41
Q
A
42
Q

5th metatarsal fracture mechanisms

A

Zone 1 Base of 5th metatarsal - inversion with traction avulsion from peroneus brevis
WBAT stiff soled shoe

Zone 2 Jones fracture - Forefoot adduction
Cast NWB

Zone 3 Proximal diaphysis - march fractures - repetitive stress
Cast NWB

43
Q

Lisfranc injury mechanism

A

Axial loading on plantar flexed foot
Fixed hindfoot, rotational force forefoot
Direct trauma

UCPEX (13 decks)

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