Orthopaedics Flashcards
What is adhesive capsulitis?
Thickening and contraction of the glenohumeral joint capsule and formation of adhesions.
What is the aetiology of adhesive capsulitis?
Idiopathic
Rotator cuff injury
Immobilisation
What is the main risk factor for adhesive capsulitis?
Diabetes
How does adhesive capsulitis present?
Pain before stiffness
Gradual and severe
Inability to sleep on the affected side
Usually non-dominant shoulder but can be bilateral
Restriction of ADLs occurs in adhesive capsulitis due to what?
Impaired external rotation
What are the phases of adhesive capsulitis
Phase 1 (severe pain and stiffness) lasts up to 9 months Phase 2 (stiffness) lasts 4-12 months Phase 3 (ROM increases) lasts 1-3 years
How is adhesive capsulitis diagnosed?
Inability to do passive external rotation
How is adhesive capsulitis managed?
Physio
Corticosteroid injection
Analgesia
Manipulation under anaesthesia
How does MUA aid management of adhesive capsulitis?
Inflamed ligaments are torn, which stretched the capsule.
Define Colles’ fracture.
Fracture through the distal metaphysis of the radius, within 2-3cm of the articular surface
How does Colles’ fracture usually occur?
Fall onto an outstretched hand
results in forced dorsiflexion of the wrist
What are the signs of Colles’ fracture?
Dinner fork deformity
Shortening, ulnar deviation, and dorsal deviation
How is a Colles’ fracture reduced?
The opposite of the deformity - movement forwards, downwards, and medially
After reduction, how is a Colles’ fracture managed?
Back slab and repeat X-Ray
Wrist immobilisation
Surgical reduction if intra-articular fractures
Give three complications of Colles’ fracture.
Median/ulnar damage: acute carpal tunnel syndrome
Compartment syndrome
Mal/non-union leading to deformity
Define a Smith’s fracture?
Fracture of the distal radius, with or without ulnar involvement, that has volar displacement of the distal fragments
How does a Smith’s fracture usually occur?
Falling backwards onto an outstretched hand with the arm above it pronating as the body falls
What is the deformity of a Smith’s fracture?
Garden spade
How is a Smith’s fracture reduced?
Backwards and medially
What does a hip fracture actually mean?
Fractured proximal femur; proximal to 5cm below the lesser trochanter.
What does the term fractured neck of femur include?
Femoral neck - elderly
Femoral shaft and supracondyle - violent trauma in young adults
Stress fractures of the femoral neck
What does an intracapsular fracture of the femur involve?
Fracture of the femoral neck between the edge of the femoral head and insertion of the capsule of the hip joint
What is a complication of an intracapsular fracture of the femoral neck?
Avascular necrosis of the femoral head
What does extracapsular fracture of the femur include?
Trochanteric and subtrochanteric
Where is a trochanteric fracture?
Distal to the insertion of the hip capsule
Involves or is between the trochanters
Where is a subtrochanteric fracture?
Fractures less than 5cm below the lesser trochanter i.e. involves the proximal femoral shaft
What is the main risk factor for fractured femoral neck?
Increasing age and osteoporosis –> falls
How does a fracture of the femoral neck present?
History of a fall
Pain in outer upper thigh or groin, that may radiate to the knee
Inability to bear weight
Aggravated by flexion and rotation of the leg