Orthopaedics Flashcards
Which drugs can cause atypical stress fractures?
Bisphosphonates
What is a Pott’s fracture?
Bimalleolar fracture
Forced foot eversion
What are you worried about with scaphoid fractures?
Avascular necrosis
80% of blood supply is derived from a branch of the radial artery
What are the 4 signs of scaphoid fracture?
1) Maximum tenderness over snuff box
2) Tenderness of scaphoid tubercle
3) Pain on telescoping the thumb
4) Pain on ulnar deviation of the wrist
5) Wrist joint effusion
What is the common imaging modality in scaphoid fracture?
Xray - repeat after 2 weeks if suspicious
MRI - for clear Dx
How to manage scaphoid fracture?
If avascular necrosis - bone graft
No necrosis - immobilisation in cast
What is the Garden classification?
Hip fracture
See notes
What is the Xray sign seen on a hip # in avascular necrosis?
Crescent sign
How to treat a hip # with avascular necrosis?
Joint replacement
What is the most common type of hip dislocation?
Posterior dislocation
How to treat hip dislocation?
ABCDE
Analgesia
Reduce under GA within 4hrs to reduce risk of avascular necrosis
Physiotherapy
Complications of hip dislocation?
Sciatic/femoral nerve injury
Avascular necrosis
Osteoarthritis
Recurrent dislocation
What is the investigation for a lateral epicondylitis (tennis elbow)?
Extend wrist against resistance
Presentation and treatment for compartment syndrome?
Presentation: Pain, especially on movement Parasthesiae Pallor The presence of a pulse does NOT rule this out
Treatment:
Prompt + extensive fasciotomies
How can compartment syndrome lead to an AKI?
Increased pressure in fascial space may -> muscle breakdown and myoglobin release (rhabdomyolysis) -> myoglobin deposited in renal tubules may lead to AKI
What are the four functions of the meniscus?
1) Buffer between the joint
2) Shock absorption system
3) Lubrication
4) Limits flexion and extension
Treatment of meniscal tears?
Knee immobilisation Ice NSAIDs Do not fully weight bear Advice to return if no improvement Surgical – meniscal repair/meniscectomy
Three typical S+S of a fracture?
Pain, swelling, deformity
Signs of NAI?
Inconsistent story Fractures in immobile children Delayed presentation Repeated injuries Withdrawn child
S+S of rotator cuff injury?
Pain and weakness
Shoulder crepitus
Muscular atrophy of the deltoid causing asymmetry
Swelling
