Orthopaedics Flashcards
What is the definitive management of compartment syndrome?
Fasciotomy
Which two fractures most commonly cause compartment syndrome?
Supracondylar fractures and tibial shaft injuries.
What is the underlying pathology of compartment syndrome?
Raised pressure within a closed anatomical space
What are the features of compartment syndrome?
Pain (esp on movement)
Parasthesiae
Arterial pulsation may still be present (necroses occurs as a result of microvascular compromise
What is reported on an XRay where compartment syndrome is the diagnosis?
Normal
How is compartment syndrome diagnosed?
Intracompartmental pressure measurements
- > 20mmHg = abnormal
- > 40mmHg = diagnostic
Name 3 types of bone sarcoma?
Osteosarcoma
Ewings sarcoma (although also seen in non-boney sites)
Chondrosarcoma (originate from chondrocytes)
What is meant by ‘open fracture’?
Disruption of the bony cortex associated with a breach in the overlying skin
What system is used to grade open fractures?
Gustilo and Anderson system
What are the grades of the Gustilo and Anderson system for open fractures?
1 - Low energy wound <1cm
2 - >1cm + moderate soft tissue damage
3 - high energy wound, >1cm, extensive soft tissue damage
- 3A: criteria of 3 + adequate soft tissue coverage
- 3B: inadequate soft tissue coverage
- 3C: associated arterial injury
Often picked up on newborn examination
Barlow’s test, Ortolani’s test are positive
Unequal skin folds/leg length
What is the diagnosis?
Developmental dysplasia of the hip
Typical age group = 2-10 years
Acute hip pain associated with viral infection
Commonest cause of hip pain in children
What is the diagnosis?
Transient synovitis
What is Perthes disease?
Degenerative condition affecting the hip joints of children, due to avascular necrosis of the femoral head
What gender and age is the typical Perthes disease patient?
Male 5:1
Aged 4-8yrs
What are the clinical features of Perthes diease?
Hip pain - develops progressively over a few weeks
Limp
Stiffness
Reduced range of hip movement
