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FINALS revision - @medicbotanist > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

Types of Fracture:

What is a comminuted fracture?

A

This is a fracture that is made up of lots of splinters.

Defined as more than 2 pieces

Ax normally trauma

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2
Q

Fractures:

What is a delayed union fracture?

A

This is when a fracture is taking longer than expected to heal.

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3
Q

Fracture:

What is a green stick fracture?

A

Mostly seen in paediatrics as occurs in those with soft bones.

Sudden force only breaks the outer side of the bone.

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4
Q

What is a malunion fracture?

A

Healing of a fracture at an incorrect anatomical alignment.

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5
Q

Fracture:

What is a non union fracture?

A

Absence of healing in a fracture

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6
Q

Fractures:

What is an oblique fracture?

A

Bone broken at an angle

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7
Q

Fracture:

What is a spiral fracture?

A

This is when you have a fracture that is caused by a twisting force around an oblique fracture.

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8
Q

Fractures:

What is a transverse fracture?

A

Fracture in the horizontal plane.

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9
Q

Fractures:

What is a union fracture?

A

Healing of fracture fragments.

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10
Q

What is the 4 step management plan for any fracture?

A

Analgesia

Reduce

Immobilise

Rehab

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11
Q

What is a good study to look at for fracture information?

A

Trauma Audit Research Network (TARN)

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12
Q

What are 4 causes of cauda equina?

A

Trauma

Infection

Tumours

Herniation of a lumbar disc

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13
Q

Describe the pathophysiology behind compartment syndrome?

A
  1. You get muscle swelling.
  2. The pressure is higher in the muscle than the artery. This means that the muscle no longer gets as much blood supply and becomes ischaemic.
  3. This can cause muscle and nerve death alongside absent pulses
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14
Q

What are 4 causes of compartment syndrome?

A
  1. Trauma
  2. Tight bandages or tourniquets
  3. Continued pressure on a limb i.e old person who fell and is now lieing on the floor (rhabdomyosis)
  4. Chronic in athletes due to frequent rhabdomyosis
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15
Q

What are the clinical features of a patient with compartment syndrome?

A
  1. Pain out of proportion with appearance.
  2. Pain on passive flexion of the toes and feet
  3. Pain not managed by analgesia
  4. Pain not relieved by immobilisation
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16
Q

What does the pressure have to be in compartment syndrome?

A

The pressure needs to be more than 30 mmHg

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17
Q

What is the gold standard investigation for compartment syndrome?

A

Compartment pressure measurement test.

> 30 mmHg

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18
Q

What is the management for compartment syndrome?

A

IV analgesia , IV fluids and Catheter

Fasciotomy

Keep the leg above the head

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19
Q

What med + vaccine do you need to give to someone after presenting with an open fracture?

A
  1. Antibiotics

2. Tetanus

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20
Q

How would you manage the following open fractures?

A. Ready for permanent fixation

B. Not ready for permanent fixation

A

A. Internal screws

B. External screws

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21
Q

What are 4 complications of an open fracture?

A

Compartment syndrome

Amputation

Non union of the bone

Infection

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22
Q

Give 3 reasons why someone wouldn’t need C spine support?

A

No pain in neck

No neuro signs or symptoms

Full 360 movement in neck

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23
Q

What is the largest tendon in the body?

A

The Achilles’ tendon

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24
Q

What is the normal cause of Achilles’ tendon rupture?

A

Rapid acceleration or deceleration

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25
Q

What two muscles does the Achilles’ tendon attach to the calcaneus ?

A
  1. Gastrocnemius

2. Soleus

26
Q

What is the presentation of Achilles’ tendon rupture?

A

Pain

Limp

Unable to stand on tip types

Localise swelling

27
Q

What triad is Achilles’ tendon rupture associated with?

A

Simmond’s Triad:

  1. Localised swelling
  2. Calve squeeze doesn’t cause plantar flexion
  3. Foot will dangle dorsiflexed
28
Q

What is the investigation of choice for Achilles’ tendon rupture and what is the management?

A

US

Management = rest or surgery

29
Q

What drug combination is associated with an Achilles’ tendon rupture ?

A

Ciprofloxacin and Steroid

30
Q

Who is De Quervain’s Tenosynovitis common in?

A

Tennis, golf players and any one who does repetitive movement

31
Q

Is De Quervain’s Tenosynovitis Finklestein Manoeuvre positive or negative?

A

POSITIVE

32
Q

What area of the arm does de Quervain’s tenosynovitis effect?

A

It affects the extensors

33
Q

Describe how De Quervain’s Tenosynovitis would present?

A

Gradual onset

Pain exacerbated by pinching or grabbing

34
Q

What are the 3 stages of managing De Quervain’s Tenosynovitis?

A
  1. Rest + Splint + NSAIDs + Physio
  2. Not settled after 4-6 weeks give a steroid injection
  3. Surgery in very resistant cases.
35
Q

What is dupuytren’s contracture?

A

Deformity of the 4th finger.

Due to contraction and fibrosis of the aponeurosis

36
Q

What will be felt on the palm of a patient with dupuytren’s contracture?

A

Tender nodule on the palm

37
Q

What test will someone with dupuytren’s contracture be positive with?

A

Hueston Table Test positive. Unable to put hand down flat

38
Q

How do you treat dupuytren’s contracture>?

A

Collagenase Injections

Radiotherapy

Surgery

39
Q

What scale is used to measure hip fractures?

A

Garden scale

40
Q

What is the management of a patient with an intrascapular NOF with no displacement?

A

Internal fixation

41
Q

What is the management of a patient with an intrascapular NOF with displacement?

A

Total hip replacement

42
Q

What is the management of a patient with an extrascapular NOF ?

A

Internal fixation

43
Q

What is intersection syndrome ? Who is it associated with?

A

This is a flexor disorder . Hard to distinguish from de Quervain’s.

Seen commonly in rowers and weight lifters.

44
Q

What will the finklestein test be in intersection syndrome?

A

Negative

45
Q

What is the management of intersection syndrome ?

A
  1. Rest and splint
  2. Steroid injection
  3. Surgery
46
Q

When is plantar fascia pain worse?

A

On a morning

Post exercise

47
Q

What are 3 investigations you would like to do in suspected plantar fasciitis ?

A

Inflammatory Markers:

X- Ray

US

48
Q

What is trigger finger?

A

It’s a type of flexor Tenosynovitis

Affects the thumb, 3rd and 4th fingers

Tender node

Can only straighten the finger manually.

49
Q

How do you manage trigger finger?

A

Splinting

NSAIDs

Steroid injections and Surgery

50
Q

What classification do you use to judge the severity of Pelvic Injuries?

A

Young Burgess Classification

51
Q

Why is a pelvic fracture so life threatening?

A

The pelvis involves many key structures: including the reproductive organs, nerves and blood vessels

52
Q

What are the 3 causes of pelvic fractures ?

A
  1. RTA accident
  2. Secondary to avulsion fractures: muscle contractions in runners
  3. Osteoporosis
53
Q

How will a pelvic fracture present?

A
  • Tenderness, bruising and swelling
  • Haematomas
  • Rectal Bleeding or haematuria
  • Neurovascular complications
  • instability of the hip adductors
54
Q

What are 3 signs of an unstable pelvic fracture?

A

Pain and Shock

Pelvic instability

55
Q

Under the Young Burgess Classification.

What does it stay are the definitions of Type A, Type B and Type C fractures?

A

Type A: avulsion and stable fractures

Type B: rotationally or vertically unstable. Or a compression fracture

Type C: rotationally and vertically unstable. Disruption at 2 or more places. Associated with an increased blood loss and increased mortality

56
Q

How do you manage young- burgess classification

Type A

Type B

Type C

A

Type A: bed rest , analgesia, physio and possibly LMWH

Type B and C: do life support avoid rolling and instead perform a straight lift.

Fluid Resus + bloods and fluids
Reduce pelvic volume with binders and external fixation
Needs surgery

57
Q

What are 3 complications of pelvic fractures?

A 
Uro gynae damage 
Compartment syndrome 
Haemorrhage 
DVT 
Sexual dysfunction 
Chronic Pain
58
Q

What is a ~Monteggia fracture

A

Monteggia fracture (3): a fracture of the proximal ulna in association with a dislocation of the proximal head of the radius. It is most commonly seen in children aged between 4 and 10 years.

59
Q

What is a galeazzi fracture

A

A Galeazzi (4) fracture is a fracture of the distal radius with an associated dislocation of the distal radioulnar joint.

A method to remember the difference between the two of these is by combining the name of the fracture with the bone that is broken:

Monteggia ulna (Manchester United), Galeazzi radius (Galaxy rangers)

60
Q

What is a Bennett fracture

A

A Bennett’s fracture (2) is a fracture of the base of the first metacarpal, that extends into the carpometacarpal joint.

FINALS revision - @medicbotanist (20 decks)

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