Orthopaedics Flashcards
Describe the causes of Achilles tendon rupture
?
- Middle aged man;
- Infrequent sports goer;
- Repetitive jumping motion.
Describe the Simmond’s triad for the diagnosis of Achilles tendon rupture
?
Patient in prone position:
- Affected leg rests in a dorsiflexed position;
- Palbable gap at the heel;
- No plantar flexion when calf is squeezed.
What is the management of Achilles tendon rupture
?
Same day referral to orthopaedics.
What medications can contribute to Achilles tendon rupture
?
Fluoroquinolones
- Increases the risk of tendinitis and tendon rupture.
Ex: ciproflocxacin.
Describe the Thompson test for Achilles tendon rupture
?
Calf is squezeed ➝ reduced/absent plantar flexion.
Indication of tendon discontinuity.
What are the muscles group affected in Achilles tendon rupture
?
HIGH YIELD
- Gastrocnemius
- Soleus
Describe the presentation
of Baker’s cyst / popliteal cyst.
- Popliteal mass;
- Occasional pain;
- Cyst rupture ➝ calf sweeling and pain.
How is the diagnosis
of Baker’s cyst / popliteal cyst done?
Ultrasound.
What are the symptoms of frozen shoulder / adhesive capsulitis?
- Pain;
- Stiffness of the shoulder;
- Restriction of active and passive shoulder movements;
- Inability of doing passive external rotation.
What is the cause of frozen shoulder / adhesive capsulitis?
- Thickened and contraction of the glenohumeral joint capsule;
- Formation of adhesions.
What is the Rx of frozen shoulder / adhesive capsulitis?
- Paracetamol and NSAIDs
- Physiotherapy
- Steroid injection
What is the commonest cause of shoulder pain?
Rotator cuff disorders.
Name the 4 rotator cuff muscles.
- Supraspinatus;
- Infraspinatus;
- Teres minor;
- Subscapularis.
What is the cause
of Rotator cuff disorders?
- Rotator cuff tears;
- Calcific tendonitis;
- Subacromial impingement.
What is the Rx
of rotator cuff disorders?
- Pain relief;
- Physiotherapy;
- Steroid injections (max 2);
- Surgery.
What are the symptoms
of shoulder impingement syndrome?
- Pain on shoulder movement ;
- Weakness on shoulder movement;
- Restriction of activity;
What is the cause
of shoulder impingement syndrome?
- History of repetitive overhead activity or of carrying heavy objects;
- It will cause narrowing of the subacromial space leading to supraspinatus tendinitis.
DDx between:
- Supraspinatus tendinitis
- Adhesive capsulitis
Supraspinatus tendinitis
- Difficulty lifting arm above shoulder;
- Painful arc test positive;
- Associated with injury of heavy lifting;
Adhesive capsulitis (stiff shoulder)
- Reduced active movements;
- Reduced passive glenohumeral joint movements;
- Difficulty to put on a jacket (external rotation impaired);
- Associated with DM.
What is the presentation / symptoms of Colles fracture
?
- Radial fracture (with or w/out ulnar fracture);
- Dinner-fork deformity:
Distal fragment of radius deviated backwards and laterally
.
➔ Elderly patient who has fallen on an outstretched hand.
What is the management & Rx of Colles fracture
?
- X-ray;
- Analgesia: haematoma block with lidocaine;
- Closed reduction and immobilisation with a cast;
- X-ray post reduction.
Describe the presentation
of Smith’s fracture.
- Reverse colles fracture;
-
Garden spade deformity
; - Anterior displacement of the distal fragment.
Garden spade = pá de jardinagem/machamba.
Describe the presentation
of scaphoid fracture.
➜ Most common carpal bone fracture.
- Fall on an outstreched hand;
- Tenderness on the anatomical snuffbox.