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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
What two muscles does the Achilles’ tendon attach to the calcaneus ?
1. Gastrocnemius | 2. Soleus
26
What is the presentation of Achilles’ tendon rupture?
Pain Limp Unable to stand on tip types Localise swelling
27
What triad is Achilles’ tendon rupture associated with?
Simmond’s Triad: 1. Localised swelling 2. Calve squeeze doesn’t cause plantar flexion 3. Foot will dangle dorsiflexed
28
What is the investigation of choice for Achilles’ tendon rupture and what is the management?
US Management = rest or surgery
29
What drug combination is associated with an Achilles’ tendon rupture ?
Ciprofloxacin and Steroid
30
Who is De Quervain’s Tenosynovitis common in?
Tennis, golf players and any one who does repetitive movement
31
Is De Quervain’s Tenosynovitis Finklestein Manoeuvre positive or negative?
POSITIVE
32
What area of the arm does de Quervain’s tenosynovitis effect?
It affects the extensors
33
Describe how De Quervain’s Tenosynovitis would present?
Gradual onset Pain exacerbated by pinching or grabbing
34
What are the 3 stages of managing De Quervain’s Tenosynovitis?
1. Rest + Splint + NSAIDs + Physio 2. Not settled after 4-6 weeks give a steroid injection 3. Surgery in very resistant cases.
35
What is dupuytren’s contracture?
Deformity of the 4th finger. Due to contraction and fibrosis of the aponeurosis
36
What will be felt on the palm of a patient with dupuytren’s contracture?
Tender nodule on the palm
37
What test will someone with dupuytren’s contracture be positive with?
Hueston Table Test positive. Unable to put hand down flat
38
How do you treat dupuytren’s contracture>?
Collagenase Injections Radiotherapy Surgery
39
What scale is used to measure hip fractures?
Garden scale
40
What is the management of a patient with an intrascapular NOF with no displacement?
Internal fixation
41
What is the management of a patient with an intrascapular NOF with displacement?
Total hip replacement
42
What is the management of a patient with an extrascapular NOF ?
Internal fixation
43
What is intersection syndrome ? Who is it associated with?
This is a flexor disorder . Hard to distinguish from de Quervain’s. Seen commonly in rowers and weight lifters.
44
What will the finklestein test be in intersection syndrome?
Negative
45
What is the management of intersection syndrome ?
1. Rest and splint 2. Steroid injection 3. Surgery
46
When is plantar fascia pain worse?
On a morning Post exercise
47
What are 3 investigations you would like to do in suspected plantar fasciitis ?
Inflammatory Markers: X- Ray US
48
What is trigger finger?
It’s a type of flexor Tenosynovitis Affects the thumb, 3rd and 4th fingers Tender node Can only straighten the finger manually.
49
How do you manage trigger finger?
Splinting NSAIDs Steroid injections and Surgery
50
What classification do you use to judge the severity of Pelvic Injuries?
Young Burgess Classification
51
Why is a pelvic fracture so life threatening?
The pelvis involves many key structures: including the reproductive organs, nerves and blood vessels
52
What are the 3 causes of pelvic fractures ?
1. RTA accident 2. Secondary to avulsion fractures: muscle contractions in runners 3. Osteoporosis
53
How will a pelvic fracture present?
- Tenderness, bruising and swelling - Haematomas - Rectal Bleeding or haematuria - Neurovascular complications - instability of the hip adductors
54
What are 3 signs of an unstable pelvic fracture?
Pain and Shock Pelvic instability
55
Under the Young Burgess Classification. What does it stay are the definitions of Type A, Type B and Type C fractures?
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
How do you manage young- burgess classification Type A Type B Type C
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
What are 3 complications of pelvic fractures?
``` Uro gynae damage Compartment syndrome Haemorrhage DVT Sexual dysfunction Chronic Pain ```
58
What is a ~Monteggia fracture
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
What is a galeazzi fracture
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
What is a Bennett fracture
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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