Orthopaedics Flashcards
What does the ACL prevent?
internal rotation
What does the PCL prevent?
Hyperextension and anterior translation of femur
What nerve can be injured in LCL tears?
Common perineal n.
What is ruptured in
- high lying patella
- low lying patella
- patellar tendon
2. quadriceps tendon
Patellar dislocations
- predisposing factors?
- does risk of recurrent instability increase or decrease with age?
- female, ligamentous laxity, shallow trochlear groove, valgus
- decreases with age
Symptoms of patellofemoral dysfunction?
Worse going downhill
Grinding/clicking
Stiffness after sitting for long
anterior knee pain
Commonest cause of compartment syndrome?
tibial shaft fractures
What type of pelvic fracture must be promptly reduced?
anteroposterior compression fracture
“open book” #
Is the common flexor origin the medial or lateral epicondyle?
medial
What should not be done in Golfer’s elbow?
intra - artic injections because risk of ulnar nerve injury
Fat pad sign on X-ray
radial head/neck #
Whats usually the first sign of hip pathology?
loss if internal rotation
What creates pain in trochanteric bursitis?
resisted abduction
What type of fracture is associated with a large volume of blood loss?
femoral shaft #s
light bulb sign on X-ray?
posterior shoulder dislocation
what is a Hill-Sachs lesion?
impaction fracture of posterior head of the shoulder
What is a Bankart lesion?
detachment of anterior glenoid labrum and capsule
what can present with shoulder pain, outwith shoulder pathology?
Neck problems, angina and diaphragmatic irritation
Shoulder instability - redislocation rate in under 20? in over 30?
under 20: 80%
over 30: 20%
Name of the repair to stabilise shoulder instability
Bankart repair
What can cause atraumatic instability?
Ehlers danlos
Marphans
Sign of adhesive capsulitis?
Loss of external rotation
Where are ganglion cysts commonly found?
DIPs and wrist
What type of collagen is assoc with Dupuytrens? Is it more common in M or F?
type 3 collagen
M x 10
What is mallet finger?
avulsion of extensor tendon from its insertion onto terminal phalanx
Does OA commonly affect the MCP joints?
No
What is Mortons Neuroma? symptoms? cause?
inflammation of plantar digital nerves
burning pain and tingling radiating into affected toes c
caused by high heels
grossly swollen, bruised foot, can’t weight bear
mid foot (Lisfranc) fracture - dislocation
Risk factors for achilles tendonitis/rupture?
what should never be used?
sign?
treatment?
Quinolone ABs, gout, RA
never use steroid injections
weakness of plantar flexion
tx = cast with foot plantar flexed for 8 weeks
What is hallux rigidus? gold standard tx?
1st MTPJ OA
gold standard is arthrodesis
traverse fracture - type of force?
pure bending force
spiral fracture - type of force?
torsional force
treatment for patellofemoral dysfunction
vast majority improve with physio to rebalance quads
are steroid injections useful in extensor mechanism ruptures?
no, avoid using them because theres a high risk of rupture
imaging for meniscal injury
MRI
whats mandatory in a pelvic fracture
PR
acetabulum fractures
what is essential for planning
CT
impingement - painful arc ? - ?
60-120
is acute calcific tendonitis self limiting?
what tendon does it involve?
self limiting
involves supraspinatous
associations with adhesive capsulitis
diabetes
hypercholesterolemia
most common humeral neck fracture
fracture of surgical neck + medial displacement of the shaft due to pull of pec major
monteggia fracture dislocation
fracture of the ulna with dislocation of the radial head at the elbow
galeazzi fracture dislocation
fracture of the radius with dislocation of the ulna at the distal radio ulnar joint
fingers commonest for trigger finger
middle and ring
swan neck deformity
PIP hyperextension
DIP hyperflexion
boutonniere deformity
PIP hyperflexion
DIP hyperextension
bartons fracture
intra articular fracture of the distal radius
colles fracture
often assoc with what?
extra articular # of distal radius within an inch of the joint + dorsal displacement
assoc with # of ulnar styloid in many cases
split cup sign
lunate dislocation
smiths #
stable or unstable?
treatment
volarly displaced EXTRA articular # of the distal radius
highly unstable so all need ORIF + plates and screws
# of both bones of forearm rx: adults ? kids?
adults: ORIF + plates ans screws
kids: plaster cast only bc small degree of angulation will remodel with growth
what action does the radio-capitellar joint control
… the humero-ulnar joint?
radio-capitellar - supination/pronation
humero-ulnar - flexion/extension
common extensor origin
lateral epicondyle
tennis elbow - lateral or medial epicondylitis?
lateral
what creates pain in tennis elbow?
resisted middle finger / wrist extension
no injections in golfers elbow!!!! why?
risk of damage to ulnar nerve
fat pad sign on lateral X-ray
radial head/neck fracture
AVN of hip can be 2y to …
alcohol abuse
steroids
hyperlipidaemia
thrombophilia
mortality from hip fractures at
1 month
4 months
1 year
10% at one month
20% at 4 months
30% at one year
what can cause femoral shaft stress fractures
osteoporosis
pagets
long term biphosphonates use
metastatic disease
Hallux valgus medial/lateral rotation of 1st mtrsl medial/lateral rotation of toe itself is there familial tendency? what is a bunion
medial rotation of 1st mtrsl
lateral rotation of toe itself
familial tendency
bunion = inflamed bursa over the 1st mtrsl head
gold standard surgical treatment for hallux rigidus
arthrodesis
what is pes cavus
abnormally high arch
Mortons neuroma
what causes it?
what imaging is used?
repeated trauma to plantar interdigital nerves (high heels!)
US > swollen nerve
when should an ankle # be suspected and therefore an X-ray carried out
severe localised tenderness or inability to weightier for 4 steps
ankle #
- what might bruising and tenderness medially indicate?
rupture of deltoid ligament
RF’s for achilles tendonitis + rupture
quinolone abx
RA
gout
what is simmonds test?
assessment of achilles tendon rupture
no plantar flexion when calf squeezed
