Orthopedic Flashcards
0
Q
Smith fx
A
- Distal radial fx with volar displacement and angulation
- Caused by falling onto dorsum of hand
- Uncommon fx
1
Q
Coles fx
A
- Distal radial fx with dorsal displacement and angulation
- Caused by FOOSH
- Very common fx
2
Q
Bennetts fx
A
-fx/dislocation of the base of the first metacarpal with disruption of the carpometacarpal joint
3
Q
Boxer’s fx
A
- Fx of metacarpal neck(usually of the small finger)
- Treatment= ulnar gutter splint with closed reduction
4
Q
Nightstick fx
A
-Ulnar fx of shaft with arm against blunt object
5
Q
Monteggia fx
A
-fx of the proximal third of the ulna with dislocation of the radial head
6
Q
Galeazzi fx
A
-fx of the radius at the junction of the middle and distal thirds accompanied by disruption of the distal radioulnar joint.
7
Q
Shoulder dislocations
A
- 95% are anterior
- Axillary nerve and artery are at risk
- Sulcus sign, loss of deltoid bulge
- If anterior=slight abduction and external rotation
- Treatment: reduction, immobilize for 2-6 wks, hold in internal rotation if anterior
8
Q
Osteosarcoma
A
- Malignant bone tumor
- sx= bone pain, pathologic fx, pain is worse at night
- 10-20yo, m>f
- mostly found in distal femur and proximal tibia
- 70% 5 year survival rate
- PE, labs, X-ray, CT, biopsy
- X-ray will show sunburst pattern
- Treatment: Resection with chemotherapy
- Can metastasize to the lungs
9
Q
Compartment Syndrome
A
- Increased pressure in an osteofascial compartment that can lead to ischemic necrosis.
- Etiology: fx, vascular compromise, reperfusion injury, compressive dressings, musculoskeletal injury
- Most common site is the calf. High concern in tibial fxs.
- Need to be alert if: supracondylar elbow fx in kids, proximal/midshaft tibial fx, electrical burns, or arterial/venous disruption.
- Sx: Pain, paresthesias, paralysis
- Signs: Pain on passive movement, cyanosis or pallor, decreased sensation, firm compartment
- Dx: clinical, intracompartmental pressures
- Fasciotomy is indicated if pressure is >40mmHg. Perform within 4 hours. (6-8 hours max)
- Treatment: Bivalve and split casts, remove constricting clothes/dressings, place extremity at heart level.
- Complications: contractures, muscle necrosis, nerve damage, myoglobinuria.
10
Q
Aseptic Necrosis
A
- Cell death to bone components due to lack of blood supply
- Most common in hip and shoulder
- Dx: x-ray, CT, MRI, bone scan
- Tx: surgery, bone graft, osteotomy, joint replacement
11
Q
Herniated disc
A
- Most commonly found in lumbar region
- Sx: sudden onset of severe lower back pain (electricity like)-sciatica
- Etiology: Usually due to bending or heavy lifting
- Dx: x-ray, MRI is superior (need to r/o cauda equina)
- Tx: modified activity, NSAIDs, PT(core stabilization), corticosteroid injections, oral prednisone to reduce inflammation, Surgery
12
Q
Bone cyst
A
- Benign
- Found in metaphysis of long bones
- Fluid filled
13
Q
Bone tumors
A
- Most common is metastatic(from breast, lung, prostate, kidney, thyroid, and multiple myeloma)
- Presentation= bone pain, pathologic fx
- Benign= osteochondroma, enchondroma, unicameral/aneurysmal bone cysts, osteoid osteoma, chondroblastoma, fibroxanthoma, fibrous dysplasia, nonossifying fibroma.
- Malignant= multiple myeloma, osteosarcoma, chondrosarcoma, ewings sarcoma, giant cell tumor, malignant melanoma, metastatic
- Dx: PE/labs, x-ray, CT/technetium scan, biopsy
- Malignant findings= large size, poorly defined margins, aggressive bone destruction, extension into soft tissue.
- Benign findings= small, well circumscribed, sharp margins
- Treatment= Surgery (excision plus debridement), radiation and chemo.
14
Q
Ganglion cysts
A
- Usually on dorsum of hand/wrist
- Presentation: swelling, pain, difficulty moving joint
- Tx: aspiration, excision
